Stigma

Tuesday, January 31, 2006

People in Botswana can get AIDS tests, but many hesitate

They fear the disease and being shunned

THE ASSOCIATED PRESS, January 29, 2006

Gaborone- When Botswana first offered free AIDS treatment, health authorities in this country, one of the world's most infected, braced for a rush of patients.

It did not happen.

It turned out that most people were so afraid of the disease, and the frequent social ostracism, that they did not want to know if they were infected.

The reluctance to get help in one of the few African nations able to give it prompted a radical rethinking of how testing is done. Now, HIV tests are offered as a part of any medical visit.

In most places, patients are left to ask for a test themselves, then put through extensive counseling to prepare them in case HIV infection is found.

Despite years of education campaigns, the World Health Organization estimates that less than 10 percent of infected people in the African countries at the epicenter of the AIDS pandemic realize that they have the virus.

The decision of Botswana to start routine testing initially caused alarm among international health advocates, who worried that patients' rights to confidentiality and informed consent would be compromised.

"I think the first right of a human being is to be alive. All other rights are secondary," countered Segolame Ramotlhwa, the operations manager for the national treatment program known as Masa, or New Dawn.

He argues that confidentiality was being confused with secrecy, making doctors reluctant even to suggest testing for the disease.

Doctors here believe that pulling patients aside for special counseling is intimidating and helps fuel the stigma that keeps patients from seeking help.

"In fact, we found that people who had not made their minds up quite often were definitely against it once the pretest counseling was done," said Dr. Howard Moffat, the medical superintendent at Princess Marina Hospital in the capital, Gaborone.

"I think the medical profession itself ... played a major role in creating this fear of AIDS and this quite irrational reluctance to be tested."

Since the beginning of 2004, Botswana has treated HIV tests like any medical procedure.

Patients can refuse, but doctors say that most don't. They estimate that up to 35 percent of the country's 1.7 million people now know their status.

Source: Journalnow.com

HIV-positive Malaysians shying away from treatment fearing stigma

Asociated Press, 1/23/2006

Malaysia--Most Malaysians infected with HIV are unwilling to seek treatment because they are afraid of being ostracized in this conservative Muslim country, a news report said Monday.

Despite government-subsidized anti-AIDS drugs, studies showed fewer than five percent of the 65,000 documented HIV-infected Malaysians were seeking treatment, the New Straits Times said quoting Christopher Lee, the senior specialist and consultant for infectious diseases at the Kuala Lumpur Hospital.

"People are afraid of the stigma," Lee was quoted as saying.

Statistics compiled for 2003 by the government's National HIV/AIDS Treatment Registry showed that only about 1,785 HIV-positive patients were receiving care at government hospitals, while about 200 others were being treated at private medical centers, Lee said.

Lee said government subsidies allowed AIDS medicines to be sold cheaply, especially with the introduction of generic drugs from India. A cocktail of treatment drugs would cost a patient just 220 ringgit (US$62; €51) a month.

Lee was in a meeting with health officials Monday and could not be reached for further details. His assistant, who isn't authorized to speak to the press, declined to comment.

According to the Health Ministry, about 65,000 Malaysians have been diagnosed with HIV since 1986, when the first case was discovered. Of those, 9,444 developed full blown AIDS and 7,195 have since died.

Non-governmental organizations believe the official figures are too low. A U.N. estimate for Malaysia last year put the figure at 81,000 infections, saying the epidemic in Malaysia has spread from high-risk groups to the general public.

Nafis Sadik, the U.N. special envoy for HIV/AIDS in Asia, has urged Malaysia to stop ignoring its epidemic and remove the stigma attached to HIV/AIDS.

Source: China Post

The Bahamas: More AIDS Patients Shunning Treatment

by Royanne Forbes-Darville, The Bahama Journal, 21st January 2006

BAHAMAS- A disturbing trend is developing among HIV/AIDS patients in The Bahamas, health officials said yesterday.

Approximately 21 Bahamians infected with the HIV/AIDS virus died abruptly last October, the largest number of persons to die of the disease in any one month. This, according to officials, is part of a disturbing trend of patients who are not seeking treatment or follow-up care.

Dr. Perry Gomez, director of the national AIDS programme, told The Bahama Journal that if these individuals were on the anti-retroviral drug their lives could have been prolonged.

"That is the largest number of persons to die in any one month [of HIV/AIDS in The Bahamas]," Dr. Gomez said yesterday during the AIDS Secretariat’s annual breakfast at Addington House, Sands Road

"They were all people who had never been on treatment and so it really confirms and validates the need for the ‘know your status’ campaign [this year’s theme chosen by The HIV/AIDS Secretariat] because people wait too late and then they come in, crash and die."

Dr. Gomez said that it was disheartening when persons living with HIV/AIDS decide not to seek treatment when the drugs are available, and most importantly free."Part of that is due to the fear of stigma and discrimination," he said.

"So we have to continue to fight stigma and discrimination as we move forward," Dr. Gomez added. "If we can get more people with AIDS to educate the public and speak out, that would be good; however, while we do get [infected persons] to speak privately, very few people in small communities are willing to go public because most are ashamed to say ‘I have HIV/AIDS’."

In 2002, around 300 people were a part of the country’s anti-retroviral programme.
AIDS patients who once paid around $14,000 per year for the anti-retrovirals, now pay a tenth of that cost, thanks to slashed rates.

According to officials, government spends around $6 million every year to care for AIDS patients.

There are nearly 2 million people living with the disease in this region.

Director of the HIV/AIDS Centre, Nurse Rosa Mae Bain, explained it is crucial that HIV/AIDS patients take their medication.

"We have had many successes in our country," Nurse Bain said.

"We have seen a decline in new cases in HIV infection…a decline in the number of persons being admitted to hospital and this is why we are starting the mass media campaign on getting to ‘know your status’."

According to Nurse Bain, the campaign aims to encourage persons who are HIV positive to attend the hospital and have their "CD4 count and their viral load" checked so that they can begin treatment.

"But what we have started to see is an increase in deaths …and a significant number of these are in young people who knew they were HIV infected but who did not come in for treatment or follow-up care," she said.

Source: The Bahamas Journal online