SIERRA LEONE: Stigma and fear prevent uptake of vital services
By, Emily Bell, IRIN PlusNews, October 30, 2006
FREETOWN, 26 October (PLUSNEWS) - Stigma against HIV/AIDS and fear of learning one's status are slowing the uptake of free testing and treatment services in Sierra Leone.
The focus of the national response so far has been on increasing people's awareness of the basic facts of HIV/AIDS. But the concept of voluntarily discovering one's HIV status is largely alien, despite the availability of free testing at all district hospitals and a number of sites in the capital, Freetown. Most people only learn what their HIV status is after being referred for testing by their doctor.
According to a national HIV seroprevalence survey published this year, an estimated 1.5 percent of the country's roughly five million people are HIV positive.
Widespread stigma is also preventing those who know they are positive from accessing treatment services and seeking support from family and friends.
Antiretroviral (ARV) drugs are available free of charge in Sierra Leone, but the government's treatment programme is unlikely to meet its target of reaching 2,000 people by the end of 2006. Currently, only 1,178 people are receiving ARVs at public health facilities.
Arnold Macauley, acting director of the HIV/AIDS Care and Support Association (HACSA), recalled receiving his positive test result in the company of his HIV-negative fiancée in 2005 and being told by the counsellor that "this is the disease you get from being promiscuous".
The misconception that HIV can only be contracted through promiscuous behaviour or illicit sex is one of many reasons the disease is stigmatised in Sierra Leone, he said. Other mistaken beliefs include the idea that HIV is linked to bestiality or is only spread by homosexual acts.
According to Macauley, the media has not helped to dispel myths about how the virus is transmitted or the view that people living with HIV are a "living curse". As a result, self-stigmatisation is a significant problem for people living with the virus and the focus of one of HACSA's main interventions. Through skills training and confidence building, the organisation encourages positive living for infected people, even down to simply taking pride in their physical appearance.
Mariama is one of five counsellors at Connaught Hospital in central Freetown who see between 20 and 25 clients a day, most of them medical referrals.
She recalled meeting a woman suffering from an AIDS-related illness during her first nursing job in 2003. The words, "HIV POSITIVE, BE CAREFUL" were written in bold on her notes. Mariama took on the case when she realised that nobody else was prepared to, only to be challenged by her colleagues for doing so.
"It was then I decided to go into HIV nursing," she said. "The most stressful side of the job is when somebody who is young and healthy turns out to be positive, or if there is a discordant couple [one positive and one negative], although we are trained to prepare everybody for either outcome, and not to assume anything when a client walks in the door."
But the general public remains unconvinced and mistrustful of the benefits of testing. Many suspect the reliability of the results or fear they will be made public.
Dr Brima Kargbo, director of the National AIDS Secretariat (NAS), emphasised that Sierra Leone's HIV/AIDS programme was still relatively new and learning from the experiences of other countries. He felt that people would only learn to trust the system if they actually went for an HIV test.
"We are trying to encourage more agencies to become involved in social marketing of HIV testing," he said. "And if we can secure further funding from the World Bank, we would like to see a model of door-to-door mobilisation, as accessibility to testing sites is still a major barrier in some districts."
eb/ks/kn/he
Source: http://www.plusnews.org/aidsreport.asp?reportid=6499
FREETOWN, 26 October (PLUSNEWS) - Stigma against HIV/AIDS and fear of learning one's status are slowing the uptake of free testing and treatment services in Sierra Leone.
The focus of the national response so far has been on increasing people's awareness of the basic facts of HIV/AIDS. But the concept of voluntarily discovering one's HIV status is largely alien, despite the availability of free testing at all district hospitals and a number of sites in the capital, Freetown. Most people only learn what their HIV status is after being referred for testing by their doctor.
According to a national HIV seroprevalence survey published this year, an estimated 1.5 percent of the country's roughly five million people are HIV positive.
Widespread stigma is also preventing those who know they are positive from accessing treatment services and seeking support from family and friends.
Antiretroviral (ARV) drugs are available free of charge in Sierra Leone, but the government's treatment programme is unlikely to meet its target of reaching 2,000 people by the end of 2006. Currently, only 1,178 people are receiving ARVs at public health facilities.
Arnold Macauley, acting director of the HIV/AIDS Care and Support Association (HACSA), recalled receiving his positive test result in the company of his HIV-negative fiancée in 2005 and being told by the counsellor that "this is the disease you get from being promiscuous".
The misconception that HIV can only be contracted through promiscuous behaviour or illicit sex is one of many reasons the disease is stigmatised in Sierra Leone, he said. Other mistaken beliefs include the idea that HIV is linked to bestiality or is only spread by homosexual acts.
According to Macauley, the media has not helped to dispel myths about how the virus is transmitted or the view that people living with HIV are a "living curse". As a result, self-stigmatisation is a significant problem for people living with the virus and the focus of one of HACSA's main interventions. Through skills training and confidence building, the organisation encourages positive living for infected people, even down to simply taking pride in their physical appearance.
Mariama is one of five counsellors at Connaught Hospital in central Freetown who see between 20 and 25 clients a day, most of them medical referrals.
She recalled meeting a woman suffering from an AIDS-related illness during her first nursing job in 2003. The words, "HIV POSITIVE, BE CAREFUL" were written in bold on her notes. Mariama took on the case when she realised that nobody else was prepared to, only to be challenged by her colleagues for doing so.
"It was then I decided to go into HIV nursing," she said. "The most stressful side of the job is when somebody who is young and healthy turns out to be positive, or if there is a discordant couple [one positive and one negative], although we are trained to prepare everybody for either outcome, and not to assume anything when a client walks in the door."
But the general public remains unconvinced and mistrustful of the benefits of testing. Many suspect the reliability of the results or fear they will be made public.
Dr Brima Kargbo, director of the National AIDS Secretariat (NAS), emphasised that Sierra Leone's HIV/AIDS programme was still relatively new and learning from the experiences of other countries. He felt that people would only learn to trust the system if they actually went for an HIV test.
"We are trying to encourage more agencies to become involved in social marketing of HIV testing," he said. "And if we can secure further funding from the World Bank, we would like to see a model of door-to-door mobilisation, as accessibility to testing sites is still a major barrier in some districts."
eb/ks/kn/he
Source: http://www.plusnews.org/aidsreport.asp?reportid=6499
posted by AIDS-Care-Watch at 4:23 pm
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