Yes, we have HIV too, say four clergymen

By Tony Kago Daily Nation, Nairobi, Kenya 22nd June 2005

Nairobi--The Christian and Muslim clergy from various African countries cited fear of stigma and discrimination as the main obstacles to the fight against the Aids pandemic. Anglican lay leader Gibson Mwangangi Mwadime (Kenya), pastor Amin Sandewa (Tanzania), Canon Gideon Byamugisha(Uganda) and Catholic priest Jape Heath of South Africa revealed their status at a forum organised by the Kenya Network of Religious Leaders Living with or Personally Affected by HIV/Aids at a Nairobi hotel.

They won accolades from Kenya's Anglican Archbishop, the Most Rev Benjamin Nzimbi, and Information and Communications minister Raphael Tuju for their boldness. Said archbishop Nzimbi: "Hearing the testimony today, I could not help shedding tears. I feel like an accused in a court. Coming out to fight stigma is a big and bold step."

He apologised on behalf of church leaders for not confronting stigma head-on. "We want to apologise for the things which we have done and for leaving out things which we ought to have done," he said.

The archbishop asked the Government to make drugs available and affordable to HIV carriers.

Mr Tuju said: "We have come a long way and to be sitting in this room with religious leaders living and affected by HIV/Aids. This is evidence that change is on the way. It will continue and it is inevitable."

Earlier, Mr Mwadime, who is based in the Taveta Anglican diocese, said he had had HIV/Aids for more than 20 years and had lost his wife and two children to the disease. He had been infected by his wife soon after she had undergone a blood transfusion during an operation.

Pastor Sandewa said he had been discriminated against by his church soon after he was infected in 1999. Canon Byamugisha, who has been HIV-positive for 18 years, said: "Many of Africa's deaths are preventable, postponable and reversible if only we can defeat the stigma, shame, discrimination, denial and inaction."

Credited with being among the first religious leaders to declare their status, Canon Byamugisha said: "We must defeat stigma. It frustrates God's world vision for mankind."

For his part, Father Heath, chairman of the African Network of Religious leaders living with or personally affected by HIV/Aids, said: "Though HIV/Aids is bigger than the church, it is not bigger than God."

Ms Rukia Ahmed of Moyale said most Muslims were "still in denial", adding: "Many people are being buried every day. Yet our people say they died because of malaria. We should come out and speak out."

Ms Rukia, a mother of three, told the Nation that, contrary to reports, North Eastern Kenyans were also infected and affected by the epidemic.

USAid's senior regional HIV/Aids adviser, Mr Warren Buckingham, who has had HIV/ Aids for 27 years, decried the lack of vision among religious leaders. "Where vision has been articulated by religious leaders, too much of it and for too long has been a vision of judgement and damnation, of punishment and persecution."

Calling for a new vision where stigma, denial, discrimination, inaction and "misaction" are non-existent, Mr Buckingham asked religious leaders to play their role as witnesses of hope and forces for change.

He asked the Government to speed up the drugs tendering process, saying the delay was costing lives. Mr Buckingham welcomed Mr Tuju's assurance that the Government had waived duty on anti-retroviral drugs.

Source: Procaare eForum, join-procaare@eforums.healthdev.org

Fear keeping infected from getting HIV tested

by Cyndy Cole, Arizona Sun Times, 26 June 205

Arizona, USA- For every person in Coconino County who knows they're HIV-positive, there's one that doesn't but might suspect as much, health officials say.
A portion of teenage girls and young women fear upsetting their lovers by demanding men use condoms, so they get on the birth control pill and skip the latex.

Some Native American patients diagnosed as HIV-positive avoid hospitals for treatment as a result of cultural stigma, until serious illness or AIDS sets in.

People who have unsafe sex with multiple partners have started thinking the AIDS pandemic, and their potential health problems, can be solved with a pill.

Misinformation and lack of education about the virus is common across northern Arizona, Flagstaff Medical Center registered nurse Adrienne Hyman says.

On Monday, the county will offer free, confidential HIV testing and counseling at its main office as part of a national campaign to get people tested. It takes 20 minutes and the prick of a finger for results.

HIV or the AIDS virus it causes affects more than 10,000 people statewide. It's aquired through blood, contaminated syringes or needles, sex with someone infected or transmitted from a pregnant woman to her fetus.

Coconino County had 118 people diagnosed as HIV-positive or living with AIDS as of two years ago, according to state statistics.

That's one in 1,030 residents affected, half as many as the statewide average but an increase from the 41 cases diagnosed in the five years before.

Oddly enough, those most likely to be HIV-postive are least likely to show up for test results, health workers said.

"There're a lot of people who don't want to know their status, who think they are (HIV-positive), but don't want to know," Hyman said.

Half who get tested are at high risk for the virus, due to risks like unprotected sex or intraveneous drug use with dirty needles, according to confidential surveys.

The other half are just verifying their health, Coconino County's HIV testing and program coordinator Ryan O'Donnell said.

FMC physician Mark Lacy, who specializes in infectious diseases, opened a clinic in the hospital this spring just for treating HIV-positive patients from across northern Arizona. Lacy and Hyman help HIV-positive patients find medicine, financial aid and other help, along with medical treatment.

Before that, the closest such specialist was in Phoenix or Gallup, N.M.

He and Hyman see about 75 patients from all over northern Arizona as part of what they call the Shandiin Project and teach educators how to talk about health and sex.

Nearly half of their patients are women, a turnabout from countywide statistics that show three out of four HIV-positive or AIDS-infected people are men.

The county health department has gotten more creative about safe-sex and health education in the past year, following Tucson in recruiting about a dozen educators to take stories about resolving risky behavior to gay and lesbian friends.

Flagstaff doesn't have a gay hangout like some metropolitan areas, so this is the next best way to get the message out, Community Promise Program Coordinator Cheryl Has No Horse said.

About half of those diagnosed as infected in the most recent county statistics were gay or bisexual men, though that trend is changing nationwide.

Source: Arizona Daily Sun at http://www.azdailysun.com/non_sec/nav_includes/story.cfm?storyID=110867

Giving women reason to hope

By Bettijane Levine LA Times Staff Writer

June, 24, 2005, NEW YORK — Babalwa Mbono wined, dined and traipsed around Manhattan as if she were accustomed to the kinds of places she went: a party in a millionaire's postmodern loft, the gleaming corporate headquarters of Johnson & Johnson, the well-appointed apartment she stayed in during her trip.

In truth, she had never seen anything like them.Her home in South Africa is a cardboard hut. She uses a communal outhouse, gets water from the streets or the town tap. Her village of Kyalitsha, just outside Cape Town, is ravaged by AIDS, as is most of her homeland. Her two young sons are among the 1 million babies born in South Africa each year to HIV-positive women, often contracting the virus at birth.But Mbono is not the tragic figure one might expect from that thumbnail sketch.

Articulate, intelligent, with a quick sense of humor, she recently traveled here on a fundraising mission led by the man she believes saved her life.Mitch Besser, an obstetrician and gynecologist from San Diego, moved to Cape Town 4 1/2 years ago to try to help curb the raging AIDS epidemic that he says is "creating a nation of orphans" and eradicating a generation of mothers. He quickly found that medical expertise was useless unless women like Mbono were willing to take advantage of it. But they were terrified of even taking the HIV test, he says.

"The big issue is stigma," Besser explains. "Just taking the HIV test is a sign to your partner, your family, the community, that you might be at risk. To be perceived that way means you will be ostracized and abandoned by family and friends." Mbono amplifies: "If you have HIV," she says, "no one wants to be with you, talk with you, let you into their house. Even the boyfriend or husband who gave you the illness may push you out, with no way to get food, no place to live."These psychological and social pressures are almost as daunting as the virus itself, both say.

To help eliminate misinformation in a country with so little public health education, so few doctors and nurses, Besser's idea was to train the women themselves — as educators, motivators, informed supporters of one another. In his Mothers' Programmes, pregnant HIV-positive women are taught methods to prevent transmission of the virus from mother to child, before and after birth. They learn about medications, nutrition, formula feeding — and how to combat societal pressures. Once their babies are born, they become mentors to the next group of newly diagnosed pregnant women.

The program started at one Cape Town maternity clinic three years ago and has since expanded to 64 sites across the country. Besser plans to extend it into Botswana, Ethiopia and Mozambique within the next three months, he says. Most South African women are not even offered an HIV test until they become pregnant and go to a maternity clinic for an exam, Mbono says. By then the stakes are even higher: "If they test positive, they consider it a death sentence for them and their unborn child." Most believe their only option would be to "have an abortion or kill themselves," she says.

She has seen it all firsthand. Her sister committed suicide after being diagnosed positive at 18. "She just couldn't take the stress, couldn't take the virus within herself," Mbono says. Although the HIV virus is an equal-opportunity attacker, to Mbono it seems it is women who suffer the most humiliation and indignity.

Now 30, she became pregnant with her second child three years ago. She took the test, quite certain she was healthy. She remembers exactly what happened next."The counselor tell me, 'Babalwa, you are positive.' I was so shocked. I just closed my eyes. I said, 'Tell me again.' " The counselor told her two more times, even showed her the form that read "positive" in heavy black ink.

"I can't explain how I was feeling, so angry at everything. I tell myself, 'This is my husband that brought this to me. I am going to be sick and die. My baby is going to be infected and die. How am I going to leave my firstborn child, and he is still so young?' "Mbono was more fortunate than her sister. The clinic where she tested had just started offering Besser's program.

The counselor took her to the mentoring group, just a few steps away. She refused to look in. "I didn't want to see sick women and their dying babies," she says. But when she opened her eyes, she remembers being "shocked and relieved. Because I see happy people. I see healthy moms and their healthy children playing on the floor."Mbono now believes that single act of joining the group has saved her life, certainly the life of the child she was carrying.

Exporting success
In California, Besser, 51, had a large private practice and headed the maternal HIV clinic at UC San Diego from 1990 to 1999, where, he says, there has not been a single case of mother-to-child transmission among clinic patients in the last 10 years. "If we could make it happen there, why not elsewhere?"

He looked to South Africa, where the AIDS epidemic is growing exponentially. But in such a struggling young democracy, with so many urgent priorities, elimination of HIV has not been at the top of the government's list, Besser says. There has been little education, testing or available medication, especially in poverty-stricken areas.

As it stood, the overworked clinic counselors and nurses only had time to deliver the test result and quickly explain the proper medications and other precautions. "Imagine thinking you're healthy, then being told you have HIV. Your mind is spinning," says the lean, youthfully intense Besser. "You think you and your baby will die. You can't tell anyone or ask for help. And while you are thinking all this, the counselor is telling you what medication to take, how to feed the baby, how to have safe sex. All in one session, while you are traumatized. Nothing sticks. And that is the last time anyone talks to you.

"Besser is an even-featured man who, even when standing still, tilts forward as if he's about to break into a run. Like a race car idling fast, he exudes a certain kind of drama as he speed-talks in a soft, urgent purr, spewing out facts and figures to explain in a few minutes what it has taken him a lifetime to learn. Drugs and treatment protocols recently made available in South Africa are not as sophisticated and effective as those in the United States, he says. But they work. And while his program does not test or deliver medications, it is a catalyst for women to utilize what is available.

In addition to allowing women to share knowledge about how to prolong their own lives and prevent passing the virus to their babies, the program has turned into a kind of group therapy project, he says. Sharing the stigma and pressures they face has led to new methods of confronting and dismantling those problems. "Look at us," the women tell the newly diagnosed, "we are happy and healthy, and so are our kids. You can be too."Though Besser is just one of dozens of individuals and groups striving to eradicate HIV and AIDS in underdeveloped countries, his work demonstrates how one man's inspiration and drive can help change the health course of a country and the life course of those who learn about his work.

The turning point
Last February, Besser got a call that his sister Karen, 48, had gone in for minor surgery and hadn't awakened from the anesthetic. She was in a coma. He flew to her bedside in Chicago, as did Karen's best friend from college, Robin Smalley, a Los Angeles TV producer. While they were together in the hospital for two weeks, until his sister died, Besser so inspired Smalley with talk of his work that she later went to visit him in Cape Town."That week turned my life upside down," she says. "I was blown away by the courage of the women, and the job they were doing to help each other, and the joy and gratitude they feel at just doing it."

Smalley came home and asked her architect husband to move there with her for a year so she could volunteer administrative help, because "the program was exploding, and Mitch was basically running it alone." Her husband surprised her by saying yes. "I could never even get him to move to Santa Monica," Smalley says. They took their two children out of private school and have since lived in Cape Town, where she is an executive administrator for the project.

Smalley says she will continue her work with Besser even after the family returns to L.A. "I'll just fly back and forth," she says. "It's the most gratifying work I've ever done. To see so many women empowered, so many babies born HIV negative that otherwise might not have been."Another discipleGene Falk, 51, who has known Besser since their days together at Williams College, has also fallen under his friend's sway.

Until last year, Falk was a vice president at Viacom in New York. "I was in Mitch's wedding. I'm the godfather to his kids. So when I heard about Cape Town, I decided to visit." That was in 2002. "Mitch was running the Mothers' Programmes from the back of his truck. I fell in love with what he was doing."Falk visited a few more times and decided he, too, had organizational skills that could help Besser expand. He and his partner sold their New York condo in May and bought a house in Cape Town.

In fact, Besser's work has inspired all sorts of support from American corporations and universities. In New York recently to solidify those kinds of connections and to raise funds for the expansion, Besser brought along Mbono and two other mentor mothers, Queen Mda and Minky Ntelwa, to speak on what the program has meant to them.Mbono, serene and eloquent, explained to anyone who asked that the group had become her true family and her emotional sustenance. Her second son was born in 2003. He does not have the virus, and she has done everything necessary to keep him that way. Mda, too, gave birth to an HIV-negative son. Ntelwa was not so fortunate. Although she took her medication as directed, she says, her son was born HIV positive. The group helped save her sanity, she says, and she is now proud to be a mentor.

The mentors, Besser says, are not just living with HIV, they are living beyond it. Because they are paid a small salary, they are becoming financially independent and entrepreneurial in other ways. Beading groups, blanket-making groups and other income-producing adjuncts are now part of the program, helping the women feed and clothe themselves and their babies. Some are even able to save small amounts, in hopes of someday buying a better house. With emotional support from the group, they have become less afraid to risk disclosing their illness. (Women in South Africa have been beaten to death after admitting their HIV-positive status, Besser says.)

To stay healthy, the women must take medication and formula-feed their babies, both of which are dead giveaways that they have the virus, Besser says, so the women don't do either if they're afraid of being found out.Some have even gone so far as to occasionally wear T-shirts that say "HIV positive and proud." They have become activists and educators, professors of a sort.

Women who would once have felt like outcasts now have a special, enlightened community of their own, one that bestows dignity and professional purpose.Besser says even he couldn't have imagined how far-reaching the program would become.

He is careful, though, to point out that he is just one of many who are working to eliminate HIV in South Africa, and nowhere near the most important, citing Fareed Abdullah, a local health official who set up the first HIV treatment program there.Besser is affiliated with three Cape Town hospitals and the university in addition to working on his Mothers' Programmes, and he also spends a portion of his time in medical research.

Until he began receiving a salary very recently, he had helped support his wife, an epidemiologist, and two young sons by flying back and forth to the United States to fill in for doctors who were taking short leaves. He was drawn to South Africa, he says, for the opportunity to make a direct difference.

"You get a sense here that you can change things — that with energy and commitment you really can help make things better. Just look at the orphan issue, for example. If we can flatten the curve of orphans created by parents dying of AIDS, just think what that means to the country and the culture…. " And he's off and running again. His impact is borne out by the mentors. "If I didn't join this group, I would already be dead," says Ntelwa. "I saw no future for me and my child with HIV. I was just facing a grave. When I started the program, I started a whole new life."

Source: Los Angelos Times at http://www.latimes.com/features/lifestyle/la-et-besser24jun24,0,3075873.story?page=2&coll=la-home-style

Kenya: SIMA helps to fight HIV related stigma

SIMA is a community based organization started in 1993 and registered in 1994 with the government of Kenya. Since its inception, SIMA has addressed issues related to HIV/AIDS and poverty. Due to wide field of operation, SIMA has found it necessary to collaborate with stakeholders and has since established its networks with registered organizations at grassroots, national and international.

The HIV/AIDS pandemic has continued unabated despite efforts by individuals and groups to curb new infections; cases of suicide committed by HIV positive person’s and stigma & discrimination are on the rise. This calls for persistent efforts right from the grassroots level in managing the trends. The Trans-Nzoia district is among the top five in the Rift Valley province in Kenya. Especially areas such as: Matisi location, Waitaluk location, Kiminini division, Korongolo/Kampoi areas, Amuka Farm, Lukhome Sub location and Sivanga location needs diversified support to counter the diverse cultural, social, economic, religious and political attitudes & behaviour that tend to contribute to rising HIV infections trends: Since the district is cosmopolitan with over 31 tribes of the 42 tribes of Kenya.

AIMS & ACTIVITIES
SIMA’s programmes are aimed at reducing new HIV infections, offering basic support to people living with HIV/AIDS and AIDS orphans, and establishing an effective behavior change for positive living by 2006, counseling, training, home based care provision, education support, community mobilization/sensitation, legal representation of sexually abused, rape, IGPS development and capacity building.

“HIV infection is not what might kill me but the though of rejection and negative altitudes from most people a round me” said one respondent for a person with HIV/AIDS, the feeling of rejection by society and family is a devastating experiences.

Rejection is not always the result of judgment and censure on moral grounds. Often, it occurs because the family members, friends and neighbours do not know how to cope with a person who is suffering from AIDS and the misguided fear of contracting the diseases. They feel awkward, embarrassed and therefore, withdraw from the person who most needs their love and friendship.

Through visiting those people living with HIV and we have experienced, there is a lot of stigma associated with the disease and a lot of care and support is required to assist those infected and affected to help them LIVE more meaningful LIVES. As a result of one or more family members being infected or having died of AIDS, the surviving family members especially the children are greatly affected. The burden of providing for those infected and affected is enormous as there is a loss or reduction of income due to frequent illness; loss of employment with the closure of small-scale business due to stigmatization and or all the money from the business is spent on drugs and food.

Due to their frequent illness, people living with HIV/AIDS (PWHA) and their families are reduced to abject poverty. Their basic needs including food, medication, clothing, shelter and counseling are rarely met.

Through our experience again, many victims in the rural areas have to walk long distances (15 – 30 km) to get treatment and attend group therapy. It was noted that people who are living with HIV, respond to the news of the there HIV status with feelings of shock, fear, lonely, anger, guilt and depression. To cope with and overcome such feelings, accept oneself as a person with HIV and live a positive and meaningful life is not easy. It requires a lot of care and support from the family and community in large.

Many times, the family members do not know that one of their own is HIV positive. They get worried when she or he fails to get better and try all types of treatments to no avail. Unfortunately for others, when their HIV status is know they are rejected.

Another cases from a victim, “My father, mother and sisters assisted me in the beginning but when they realized I was HIV positive and was not getting better they slipped away – their visit are now in anticipation of my death”.

Stigmatization of those infected is rampant. HIV/AIDS related with stigma and discrimination presents a serious challenge to the effectiveness of AIDS prevention, control and care programmes. Those whose relatives, friends or neighbours know their HIV/AIDS status talked of being discriminated against.

In addition, manifestation of HIV/AIDS related stigma and discrimination differs by gender. In some areas and culture belief, in-laws regularly blame women in particular for the deaths of their husbands. In some cases women are accused of infecting their husbands as a result of their ‘perceived promiscuity’. The socio-economic status and financial security of the victims affect their stigmatization by enabling those with higher incomes access to better health care and confidentiality.

The guardians such as grandparents who are caring for their daughters- children said that it has been very difficult to care and support these children. Said one respondent whose six children’s died and left her with seven children, “we live in this small room, many times I feel very depressed, especially when the children fight for a food.”

Some of the women we interviewed admitted their husbands are repeatedly infecting them with sexually transmitted infections (STI’s) even when they know both of them are HIV positive. One woman said, “I know my husband has severally infected me with STI s but he has refused to go for counseling. I know he is HIV positive, positive like me but he tells me I am the one who is sick. He has threatened to marry another wife because I am not giving him more children. This annoys and worries me. I have tried to keep myself fit and well groomed but my husband is not appreciating.” Consequently, many of the respondents have taken measures to change their sexual behaviour. For instance over half of those counseling are currently abstaining from sex.

SIMA organises performance, theatre song & poetry, drama, traditional dancers, forming youth health clubs and other events to campaign for preventing HIV/AIDS by passing out information to the people in the entire community at the grassroots level. Also SIMA uses this information to sensitize the community affect of HIV/AIDS related stigma, discrimination and how to reduce it. So we would like to invite you, to come to discuss this further with those people living with HIV positive openly. We have a big problem in our community at grassroots level.

Contact Information:
Johnstone Sikulu Wanjala
Programme coordinator
Sima community based organization
Email: sikuluj@yahoo.com
PO BOX 1691, Kitale 30200 Kenya.
+254-733 453 339

South Africa: Fear of Stigma Still Prevents Disclosure

UN IRIN, June 13, 2005

Zeni's baby arrived prematurely while she was visiting her mother in the KwaZulu-Natal province of South Africa and was rushed to the nearby Edendale Hospital.

She had been scheduled for a caesarean section at Chris Hani Baragwanath Hospital in the country's largest township, Soweto, near Johannesburg, but gave birth by natural delivery at Edendale, about 500 km away.

Zeni was too scared to tell the hospital staff there that she was HIV-positive, so her baby boy didn't receive the nevirapine he needed. "He didn't get the syrup; maybe if he got the syrup he would have been fine," she said.

On her day off she had come to spend some time with nine-month-old Thabo, who was in Baragwanath hospital again, where was feeding him formula in a crowded paediatric ward.

His eyes were bright and he smiled readily but, with his stick-like limbs and an oxygen tube attached to his nose, he was the image of vulnerability: he is HIV-positive, has tuberculosis and is in and out of hospital with chest infections.

"My heart was very sore because at least I have had a chance to experience life - what about my son? He doesn't know anything; he is still young," she said, hugging her baby closer. "When I look at Thabo I feel like crying. I just tell myself one day he's going to get thin, because most of the people who've got this HIV thing, they get thin."

Despite her difficulties, Zeni, 30, sparkles with enthusiasm and zest for life. She has now sent Thabo off to KwaZulu-Natal to be looked after by her mother, while she tries to hold on to a poorly paid job and care for her elder son, who is HIV-negative.

So far, she has kept her status to herself - her partner, family and friends are still in the dark; only the hospital staffers know why her baby is so sick.

Like so many other women, Zeni is too afraid to disclose her status because of the persistent stigma around HIV/AIDS. "It's not easy to disclose yourself ... you are thinking ... maybe these people, they will neglect me, you see."

She is one of the roughly 25,000 women who have tested HIV-positive at Soweto's 13 public clinics over the past three years. Counsellors at the PHRU, based at Baragwanath and one of the largest AIDS research organisations on the continent, report that the inability of women to disclose their status is one of the biggest obstacles in the fight against HIV/AIDS.

PHRU psychologist Ray Lazarus noted: "Many of our counsellors feel completely frustrated and disempowered by the fact that the client won't disclose." However, as he pointed out, "experience around the world suggests that we have to think of disclosure as a process and not an event".

According to a PHRU study conducted last year, most women do eventually disclose to a family member or friend, but many still stall when it comes to their partners.

Dolores, 34, a mother of two, explained why she could not tell the father of her second child, John, that she was HIV-positive. "You know, it's a question of who came with the disease - I don't know whether I am the one who came with HIV from my first relationship, or whether John had it all the time. At the end of the day I am the one who will be blamed."

The fear of stigma and the resultant rejection is often greater than the actual experience of it. "Usually the fear in the mind is greater than the reality - women think that if they disclose they will be chucked out, but very few actually experience this," noted Zandile Myeni, director of the prevention of mother-to-Child transmission (PMTCT) project at the PHRU.

Nevertheless, the dread of being ostracised, kicked out of home or blamed for passing the virus to a baby are enormous barriers to disclosure, and the stress of keeping the secret often appears to hasten the onset of illness.

HIV is merely the latest of many diseases, including leprosy, cancer and TB, to be stigmatised, but what makes it particularly intense around HIV/AIDS is that it concerns the usually taboo subjects of sex, death and bodily wastes, such as the diarrhoea that plagues many people with AIDS-related illnesses.

Research shows that people living with HIV/AIDS are all too frequently perceived as sexually promiscuous, the 'walking dead', or contaminated and unclean.

Several women interviewed by Philippa Garson, a research fellow at 'the HIV/AIDS and the Media Project', run by the Perinatal HIV Research Unit and the school of journalism at the University of the Witwatersrand, said they would not disclose their status to family members or friends, because of the "way they talk about people with HIV".

Karabo, a receptionist who has just given birth, said she would never disclose her status to her sister, who has told her she "really hates them [people with HIV]".

"When I said to her, 'What if I have HIV?' she said, 'Then I will not see you again in my house'."
Many expected that the launch of the government's plan to provide free antiretrovirals at public health facilities would help diminish stigma by presenting HIV a chronic, manageable illness rather than a death sentence. But the pace of the rollout has been slow.

About 45,000 people are receiving the drugs, and the government is now close to meeting its target of providing treatment to 53,000 - admittedly a few months past the March 2005 deadline.

For Evelyn Keswa, who coordinates the PMTCT programme at Soweto's Lilian Ngoyi community clinic, education is the only way to eradicate stigma. "People need to understand that if I'm positive it doesn't mean I slept around more than the person who is negative; people need to accept positive people and understand that it can happen to anybody."

Source: UN IRIN -- 6/13/05