By Joyce Mukucha
When most people hear that someone is HIV positive especially Africans, they will be seeing someone who is dying, someone who is not supposed to touch anyone and someone who is of no value. The shame of the disease or disgrace is attached to something regarded as socially unacceptable.
It is estimated that around 5 million adults and 1.4 million children worldwide have already died since the start of the global epidemic.
Stigma is habitually attached to things people are afraid of. Ever since the first cases of AIDS in the early 1980s, people living with HIV have been stigmatised. There are a number of reasons for this. If undiagnosed and unmanaged, HIV can still be a serious, life-threatening illness. There is a long history of illnesses being stigmatised including cancer and tuberculosis.
In Zimbabwe, HIV stigma whether perceived or real, is more rampant in rural areas resulting in People Living with HIV (PLWHIV) being insulted, rejected, gossiped about and excluded from social activities. At its extreme, stigma can drive people to stop adhering to their medication thereby leading them to have advanced HIV. Sometimes, it can even lead to physical violence since PLWHIV are marked out as being different and are blamed for that difference.
Maria who is 24 years old (not her real name) who resides in Madamombe village in Chivhu, said at first when she was told at the age of 13 that she was an orphan born HIV positive, she felt nervous about telling others of her condition due to the fear of stigma or discrimination. She even stopped taking her medication as she tried to appear strong and fit among others. Failing to hold her tears whilst narrating her story, she said stigmatisation led to isolation and feeling unsupported, which caused negative impact on her health and wellbeing.
Maria explained that what caused her to fear that much is because her close relatives and friends in the community were segregating her to the extent that she began to think that people had negative feelings about her for being an orphan whose parents died as a result of HIV/AIDS.
“People have fears, prejudices or negative attitudes about HIV. When I was growing up, I was under the care of my aunt and I didn’t understand what was going on when she used to tell me to correctly take my medication on a daily basis. I wasn’t feeling sick but I had to take it anyway. At the age of 16, I then began to understand my situation and I had to accept that I was born like that,” Maria said.
The support, love and education Maria received from her aunt is the major reason that boosted her confidence pertaining her status.
Sinikiwe Mulaweti (Maria’s aunt) who is a community volunteer told Spiked Online Media that she did the best that she could to protect her niece’s wellbeing through imparting HIV knowledge to the community. She even formed a group called Together for Change, a membership that has a protective effect against HIV as well as contributing to stigma reduction and faster uptake of certain HIV services.
“Stigma leads to people not being treated with dignity and respect. People who don’t understand how HIV is transmitted may be afraid of ‘catching’ it through social contact. As an adult who has adequate knowledge about HIV, I felt that it was my responsibility to play my role in ensuring that the child understand and accept her status. Also, I worked hard to inform the nearest relatives and members of the society who were ignorant about the disease treating Maria in a negative manner, I didn’t want that, what I wanted was the best of her and her wellbeing,” she said.
After formation of the group, several mechanisms have been identified through which the community group might exert a positive effect on HIV prevention, care, and treatment. Gradually, she said, community members began to work collaboratively, to achieve optimal prevention, care and treatment including behaviour change, care of the sick, acceptance, kindness and practical support and assistance for the affected.
“The movement played a critical role in my community for it did not only benefit Maria but also those who are living with HIV who once lived in fear of discrimination and victimisation. The community to a greater extent embracing and accepting that being positive does not mean that you are going to die. People now understand that they have to adhere to their medication and as well they now support those who are on medication encouraging them to live a normal life without discriminating them. This is a very positive action seeing community groups act as critical enablers of the HIV response, negative norms are slowly being erased,” Mulaweti said.
According to the Zimbabwe Population Based HIV Impact Assessment (ZIMPHIA) 2015-2016 survey results, in Zimbabwe 77% of people living with HIV knew their status, 88% of those people were on treatment, and 85% of those people on treatment were virally suppressed. ZIMPHIA 2015-2016 showed significant progress towards reaching the UNAIDS 90-90-90 targets by 2020 and the global target to end AIDS by 2030.
Speaking during a national sensitization meeting of the ZIMPHIA 2020 in Harare a few months ago, the Director of AIDS and TB Unit, Ministry of Health and Child Care of Zimbabwe Dr Owen Mugurungi said there was need to continue scaling up innovations and best practices to ensure that all key and vulnerable populations that are at high risk are reached as well as ensure that relevant HIV services and products are provided.
“Ladies and gentlemen, I am quite optimistic that ZIMPHIA 2020 will help us as a Ministry, key health authorities and policymakers to have a better understanding of the overall impact of HIV on the entire population of Zimbabwe, looking beyond people living with HIV. We are elated that ZIMPHIA 2020 will provide technical assistance at the national level to strengthen data collection systems, enhance laboratory infrastructure, and strengthen local human resource capacity,” he said.