Stigma

Monday, August 14, 2006

HIV Is Treatable, It's the Stigma That's Fatal

The murder in June of Vivian Kavuma in Uganda by her lover after she disclosed that she was infected with HIV.

The brutal stabbing with a pitchfork of 15-year-old Isaiah Gakuyo last April in Kenya by his uncle simply because the orphan was HIV-positive. There were numerous witnesses to the attack, but none intervened.

The murder of in June 2005 human rights activist Octavio Acuña Rubio in a condom shop he owned in Mexico.

The arrests in December of five Zimbabwean AIDS activists commemorating World AIDS Day at a public square in Harare.

The house arrests in March this year of at least 23 people living with HIV in China's Henan Province to keep them from bringing petitions to the Chinese congress.

And the list goes on.

"We have the knowledge to defeat HIV now, we know what is effective, and that is recognising that the epidemic is caused by human rights abuses, which fuel the epidemic," Joseph Amon, director of the HIV/AIDS Programme at Human Rights Watch (HRW), told IPS.

Since the virus was first identified in the early 1980s, HIV/AIDS has claimed 22 million lives and infected over 60 million people. Last year, five million people were newly infected and three million died of AIDS.

Between 2003 and 2005, the number of people living with HIV in East Asia rose by more than 25 percent and the number of people living with HIV in Eastern Europe and Central Asia rose more than one-third.

But according to HRW and others, in the 25 years since AIDS was first discovered, few countries have succeeded in controlling the epidemic. Those that have done so have provided comprehensive information on HIV transmission to their populations, addressed the vulnerability of women and girls to violence and abuses, ensured access to condoms, clean needles and methadone, and expanded access to anti-retroviral drugs.

Experts stress that vulnerability to HIV/AIDS is closely tied to the social marginalisation of people most affected by the virus. They include young girls, injecting drug-users, sex workers, men who have sex with men, migrants and prisoners, categories which are frequently victims of discrimination and other human rights abuses.

The connection between abuses of women's rights and their vulnerability to the disease is particularly evident in sub-Saharan Africa, where 58 percent of those infected with AIDS are women. According to HRW, in 2003, half of all governments in sub-Saharan Africa had yet to adopt laws specifically banning discrimination against people living with HIV/AIDS, while only one-third of countries worldwide had adopted legal measures specifically outlawing discrimination against populations vulnerable to the disease.

"If we attack the epidemic by attacking human rights abuses we can turn the epidemic around. The way we can do that is to have comprehensive prevention and information provided to people. We need to empower communities to take the step that they need to recognise the epidemic and respond to it," Amon told IPS.

Documenting and punishing human rights abuses related to HIV/AIDS is essential in raising public awareness and fighting the epidemic. Unless countries adopt approaches to HIV that are rooted in human rights principles and informed by scientific evidence, the epidemic will keep growing, HRW says.

The need for global HIV prevention based on sound scientific evidence is supported by groups like the Caucus for Evidence-Based Prevention, a coalition of U.S.-based non-governmental organisations and their international partners whose aim is to implement strategies with proven success in lowering HIV transmission rates.

In fact, according to the multidisciplinary group of more than 30 organisations, for different reasons, too often strategies with no proven efficacy have been promoted instead of those that are known to work.

For example, in Uganda, once one of the continent's greatest success stories in reducing HIV rates, infections are now on the rise again since the government and evangelical groups have pushed abstinence-only messages and attacked the effectiveness of condoms.

In Thailand, another initial bright spot in the fight against AIDS, condom use is down and infections of sexually transmitted diseases are up. HRW says the government has done little to reduce HIV infection among drug users or migrant workers, and leading AIDS experts say that Thailand's success is "history".

In Zimbabwe, some 350,000 people urgently need anti-retroviral drugs but only about 25,000 have access to them. The life expectancy for women is 34 years -- the lowest in the world.

In the United States, African American women are 19 times more likely to be infected with HIV than white women. The number of new infections has remained static for a decade, and HRW says that "programmes that once vigorously and creatively challenged communities to confront AIDS and learn how to protect themselves from HIV are being replaced by proposals to eliminate individual pre-test counseling and written consent, and simply have doctors routinely test everyone they treat for HIV."

"One of the ways to combat the epidemic is by having greater accountability by governments, having better cooperation between civil society and governments in terms of monitoring the epidemic, having specific concrete goals and having periodic reports that include civil society in terms of tracking progress," Amon said.

"In Southern Africa, for instance, there are many policies which maintain the vulnerability of women and there is also a lack of protection and enforcement of property rights abuses. The traditional systems often do very little to respond to those abuses," he noted.

At the just-concluded Group of Eight summit in St. Petersburg, Russia, leaders of the world's richest nations adopted a document pledging to achieve "tangible progress" in the fight against HIV/AIDS by 2010. However, activists said donors must also increase funding or they would miss their own target, set last year at the summit in Gleneagles, Scotland, of providing treatment to four million Africans by that same deadline.

In order to achieve universal treatment for HIV/AIDS, at least an additional 10 billion dollars would be needed, they note.

Many hopes are now pinned on the Aug. 13-18 conference in Toronto, where HRW has called on government representatives, United Nations officials and delegates to recognise that "only by protecting the rights of those most vulnerable, and by empowering those most marginalised, can the few success stories to date in the fight against AIDS be expanded and sustained."


Source: Alberto Cremonesi, Inter Press Service News Agency

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