Focus on HIV/AIDS - Discrimination a blot on Jamaica's record

Jamaica Gleaner, by Andrea Downer, Freelance Writer

JAMAICA'S SUCCESS in controlling HIV/AIDS and meeting the commitments made at the United Nations General Assembly Special Session (UNGASS) on HIV/AIDS in 2001 is being marred by persistent stigma and discrimination which abound in all sectors, including health.

"Because of fear of being labelled, and of the negative repercussions if their HIV-positive status becomes known, people are not getting tested and they are not seeking treatment," Lilieth, a member of the Jamaica Network of Seropositives tells The Sunday Gleaner.

GREATEST INHIBITING FACTOR
Lilieth was diagnosed HIV-positive 12 years ago and cites stigma and discrimination as the greatest inhibiting factors to the successful implementation of the UNGASS commitments.

"This denial by the PLWHA (People Living with HIV/AIDS) drives the epidemic underground and means that the programmes by the Ministry of Health and other agencies that are geared towards PLWHAs are not reaching the targeted population," she explained.

Lilieth said that sometimes, even people who know their status are in denial and will even refuse to disclose their status to health care providers when they go to seek treatment for opportunistic infections. She said this withholding of information stems from the fear that disclosure of their HIV status will impact on the level of treatment that they receive.

"The fear is valid," she said, as she has witnessed instances at one urban hospital where health care workers refused to, or took hours to treat a PLWHA who was critically ill, after the PLWHA disclosed her status.

She said the young woman had undergone minor surgery and had been sent home, when a complication developed. "She began bleeding profusely and we rushed her to the hospital. They were in the process of attending to her when she informed them that she was HIV-positive. She was told to wait a little until a doctor was located. It was several hours before she was attended to."

REFUSED MEDICATION
Lilieth recounted another instance in which an HIV-positive man was admitted for 17 days at the same public hospital, and health care personnel refused to attend to him for the duration of his stay. He was eventually sent home without even receiving medication.

In a third case at the same hospital, a woman who was HIV-positive and too ill to leave her bed, was not given assistance to procure medication from the hospital's pharmacy, which was on a different floor of the hospital. She was not able to enlist the help of her family members, as she had not told them of her HIV status, out of fear that they would reject her.

The PLWHA was only able to get the medication after several days when another PLWHA came to her assistance. All three incidents occurred within a three-month period, during the first quarter of 2006.

Miriam Maluwa, UNAIDS representative in Jamaica, said stigma and discrimination, which are part of a wider societal problem, are the greatest threat to the achievement of the UNGASS goals.

"As long as stigma and discrimination exist, we will never achieve universal access," Ms. Maluwa said with strong conviction. Her views are shared by former Health Minister John Junor who cited stigma and discrimination as Jamaica's greatest challenge in fulfilling the UNGASS commitments. He also said homophobia is a major part of the problem.

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Name changed to protect identity
The article above is part of a five country series on the Caribbean's HIV/AIDS response since individual governments signed the United Nations General Assembly Special Session on HIV/AIDS Declaration of Commitment in 2001. It is now five years since those promises were made and time to assess the progress made. This is a collaborative effort between Panos Caribbean and The Gleaner.

"Positive partnerships" break down AIDS-discrimination in Thailand

UNAIDS, May 1, 2006

THAILAND--When married mother Nang Noi was told she had HIV three years ago, the fear of the disease and of the social rejection that might go with it was overwhelming. "I cried for five days straight. I did not think I could go on," she said.

But through her own personal courage, the support of family and friends, and her involvement in a project that has given her the opportunity to set up two small businesses with her sister, Nang Noi has found ways to face her fears and counter AIDS-related stigma and discrimination.
Nang Noi set up two small businesses – selling dried seafood snacks and offering traditional Thai massage – using a micro-credit business loan through Thailand’s biggest non-governmental organization, the Population and Community Development Association (PDA).

Funded by the Pfizer Foundation in Thailand, the PDA project – entitled the ‘Positive Partnership Project’ - offers loans to partnerships of people living with HIV and a "buddy"(often a friend or family member who is not living with HIV) to set up small business ventures.

As part of the terms of the project, each "buddy" undertakes to be a community ambassador for people living with HIV. "Buddies" talk to friends and neighbors about the realities of HIV, trying to replace fear around HIV with facts.

"There is a great deal of stigma against people living with HIV - even when it comes to bank loans. A widespread – and unfounded - notion existed in Thailand that people living with HIV wouldn’t be able to pay back loans," said PDA founder, Senator Mechai Viravaidya. "We felt this theory could and should be tested."

"We realized that to really make a difference, we needed to tackle the need for people living with HIV to sustain their livelihoods and to break down stigma simultaneously," he added.

Since the official launch of the project in January 2004, around 750 partnerships running micro businesses such as food-selling, motorcycle repair and craft-making have started up, supported by PDA centers in north, northeast and central Thailand. By October 2005, PPP loan repayment rates of 84% exceeded the rate of repayments within the general Thai banking system.

"Nobody is more motivated to succeed than the people who are receiving these loans," said Senator Mechai.

Taking charge of their professional lives, people living with HIV involved in the project report feeling an increase in respect shown towards them by others, and a growth in their own feelings of self-respect.

And surveys of community members in PPP project areas indicated that ten months after the loans schemes began "anxiety levels" around (or fear of) AIDS and stigma against people living with HIV had dropped from around 47% to around 14%.

"In the beginning our neighbors were afraid to buy Nang Noi’s food. But after I talked to them, and explained the realities of HIV they slowly began to change and now regularly buy from us," said Nang Noi’s sister and PPP partner Ngeun.

Patrick Brenny, UNAIDS Country Coordinator for Thailand, underlined the vital role the project plays for Thailand and for UNAIDS work in the country: "Two of the most critical challenges facing persons living with HIV infection in Thailand today are the lack of sustainable livelihoods and the challenges of stigma and discrimination, both of which are priority areas for UNAIDS’ work in Thailand," he said.

"The PPP is an excellent example of addressing the longer-term economic well-being of people living with HIV and their families, while at the same time tackling the community-based stigma and discrimination which hampers the integration of HIV positive individuals and their families into those very same communities," he explained.

"As more and more people living with HIV in Thailand gain access to antiretroviral therapy through the National Health Security Scheme, the importance of the PPP and similar initiatives will grow in order to address both the economic as well as the social- and community-support challenges facing persons living with HIV infection and their families here in Thailand," said Brenny.

Source: PartnersThailand EForum

Implementing non-discriminative policy against AIDS urged in Zambia

LUSAKA--The Zambia AIDS Law Research and Advocacy Network (ZARAN) has said that 90 percent of workers infected with HIV/AIDS in work places have been discriminated due to lack of anti-AIDS policies in most companies.

In a statement released in Lusaka Saturday, ZARAN communication officer Paul Sichalwe said Zambian businesses and government departments need to implement effective HIV/AIDS policies to stem the increase in discrimination cases.

He said private companies and the government departments should implement policies that embrace prevention, care, support and treatment for HIV positive employers, according to local media reports on Sunday.

"Without action by employers to protect the working rights of people living with HIV and AIDS, they will continue to suffer discrimination," he said.

Schalwe urged the government to support this process by implementing legislation that properly protects all Zambians from discrimination and most especially people living with HIV/AIDS.

He said ZARAN has been waiting for about five years for the government to keep its promise of enacting such legislation as a commitment made in 2001.

He said the government made the commitment under UN General Assembly special session declaration of commitment on HIV/AIDS in 2001 to enact, strengthen and enforce regulation and other measure to eliminate all forms of discrimination against people living with HIV/AIDS and members of vulnerable groups.

ZARAN is an non-governmental organization that is championing the rights of people living with HIV/AIDS through advocacy, research, education, law, policy reform and development.

Source: Xinhua