Stigma

Wednesday, April 25, 2007

MOZAMBIQUE: HIV-infected women blamed and shunned

By, IRIN PlusNews, April 20, 2007

HIV/AIDS often has more devastating consequences for Mozambican women than it does for men. When the virus is detected, they are often accused of bringing HIV into the home, and may even be rejected or abandoned by their families.

"Because I had sores all over my body and my hair was falling out, my husband would say that I smelled like raw meat and he wouldn't sleep by my side. He began to get sick and my mother-in-law said that I was the one who infected him, but the only one I was with was my husband," said Sonio Costa [not her real name], from Tete Province in the northeast of the country.

"After our two last children died, he tried to look for another wife," added Costa, who was eventually abandoned by her oldest children as well.

Costa's experience is not unique. Joselia Mbanza, the national coordinator of Kuyakana, a network of HIV-infected women, told IRIN/PlusNews: "There are people who believe that everything bad that happens to women is punishment they deserve ... and men imagine that women are the cause of AIDS."

According to Mbanze, there are many cases of family members expelling infected women. Janana (not her real name), a member of Kuyakana, at first hid the fact she was HIV positive. "I had reason to fear," she recalled. "When I appeared on television, speaking about my HIV status, I was rejected by my community and my children were discriminated against."

Blame and discrimination

Maria Cecilia de Mendonça Pedro, a sociologist, believes that women are blamed for HIV/AIDS and a host of other health issues because of their inferior position in society.

"When the children are born with genetic problems, the mother is blamed; sexually transmitted diseases, too. When the couple lacks children, the woman is blamed and the husband has the right to return her to her parents, without looking into why she couldn't get pregnant," Mendonça said.

The common method of determining the rate of HIV infections by surveying pregnant women who visit antenatal clinics has had the unfortunate consequence of linking women to HIV in the minds of many people. Constant references to this statistic reinforce the perception that AIDS is a women's disease, a UNAIDS study pointed out.

In many families the virus is only discovered when a woman becomes pregnant and tests for HIV during her prenatal consultation. Fearing discrimination and abandonment by their families, many pregnant women either refuse to be tested or, if they test positive, hide the results from their husbands and are unable to take advantage of services to prevent mother-to-child transmission (PMTCT) of HIV.

According to UNAIDS, an estimated 30,000 children are born with HIV annually in Mozambique.

Impure

Mozambican anthropologist Cristiano Matsinhe describes in his recent book, Tabula Rasa, how commonly held beliefs perpetuate the blaming of women for HIV infections. After our last two children died, he tried to look for another wife.


Based on interviews he conducted in Tete, Matsinhe attributes the perception of women as "transmitters of HIV/AIDS" to their association with "states of impurity, danger and sickness".

He writes that menstruating women are considered particularly impure, and able to transmit sicknesses to men. "Under this logic, men are considered victims of women ... who consciously or unconsciously are disposed to spreading evil." Such beliefs have become even more pervasive since the arrival of HIV and AIDS, Matsinhe noted.

But according to Kuyakana's Mabanza, traditional beliefs about the sources of illness are not confined to men, which was demonstrated when Kuyakana attempted to assist a woman who had lost her husband to an AIDS-related illness in Maciene, in the southern province of Gaza.

She believed his death had been caused by 'mudjiwa', a sickness believed to be caused by spirits. After her husband's funeral, she submitted to 'kutchinga', a ritual that consisted of having sexual relations with one of her late husband's brothers.

Another woman, who was pregnant and HIV positive, and therefore eligible to receive antiretroviral treatment, had not attempted to obtain it because she believed she suffered from "a disease that lasts a century - a woman's disease", which was untreatable.

Kuyakana is training community and government leaders, particularly in rural communities, to counter such beliefs and persuade communities to accept those living with HIV.

dm/ks/he


Source: http://www.irinnews.org/Report.aspx?ReportId=71727

Tuesday, April 17, 2007

KENYA: Legal reforms needed to protect HIV-positive people

By, IRIN PlusNews, April 16, 2007

NAIROBI - Lack of adequate legal aid for Kenyans living with HIV could reverse advances made in the fight against the disease, the Open Society Initiative for East Africa (OSIEA) has said in a new report.

'Ensuring Justice for Vulnerable Communities in Kenya: a review of HIV and AIDS-related legal services' was launched on Monday by OSIEA, a regional offshoot of the Open Society Institute, founded by international financier and philanthropist George Soros to promote human rights and good governance through grants to civil society groups.

The 40-page document catalogues human rights abuses faced by HIV-positive Kenyans, from sexual violence and property-grabbing to police abuse and discrimination, and makes recommendations for improving their access to legal services.

"Suppose an HIV-positive widow needs antiretroviral treatment but has no money to pay for her transport to the health centre because she has been denied her property rights by her late husband's family," said Jonathan Cohen, director of the Open Society Institute's Law and Health Initiative. "In such a case, the burning issue is not access to health services but to human rights and legal representation."

Cohen said the report had uncovered "startling findings", including a severe shortage of lawyers and other representatives of the legal system in Kenya.

"There is usually just one magistrate and a visiting judge in each of Kenya's 71 districts," he said. "On average, victims of sexual violence have to make 15 court appearances in order to press their cases."

Although Kenya recently passed a law to protect the rights of people living with HIV/AIDS, and another one to protect survivors of sexual violence, the country lacks a state-sponsored legal aid system, leaving expensive private lawyers and charitable organisations to fill the gap.

"Just as it is possible to scale up HIV-related health services, such as condoms, antiretroviral therapy and palliative care, it is also necessary to scale up HIV-related legal services," Cohen said. "The AIDS epidemic provides new urgency for legal aid reform in Kenya."

Allan Ragi, director of the Kenya AIDS NGOs Consortium, a national network of AIDS organisations, said that despite the existing legislation there was little political will to provide legal support to people living with HIV.

He added that all vulnerable groups, including men who have sex with men and women who have sex with women, needed access to health services and legal protection.

"It is time we stopped burying our heads in the sand - these are our brothers and sisters," Ragi said. "They need constitutional protection, just like all other Kenyans."

The OSIEA report recommends that the government incorporate legal and human rights advocacy into existing HIV/AIDS programmes, and provide support to the traditional, informal justice system by educating traditional leaders about legal and human rights relating to HIV and AIDS.

"Legal aid needs to be placed high on the country's HIV agenda and, conversely, HIV must be placed high on the legal aid agenda," Cohen said.

kr/he
[ENDS]

Wednesday, April 11, 2007

Pakistan battles HIV/Aids taboo

By, Ashfaq Yusufzai, BBC News, April 9, 2007

Nearly 4,000 people with HIV/Aids have reported at treatment centres around Pakistan, government and World Health Organisation (WHO) officials say.

The figure is a fraction of the total number of Pakistanis with the virus.

A UNAids report last year said that between 80,000 and 140,000 people were infected - and the rate could spiral because of under-reporting of cases.

The WHO has been funding a three-year, $4.5m anti-retroviral programme in Pakistan since late 2005.

'Adultery'

The drugs for the programme are imported from India, and a number of doctors and nurses have been trained for the purpose in India and Italy.

An HIV-Aids newsletter of the Ministry of Health put the total number of reported cases at 3,933, but only about 618 of them were registered with nine treatment centres countrywide.

Pakistani officials say a low detection rate and stigma associated with the disease were hampering the treatment of HIV/Aids patients.

The problem is further compounded by a lack of awareness about the infection.

"People think it is exclusively caused by adultery, and are therefore reluctant to approach health services," says Quaid Saeed, WHO's national medical officer for HIV/Aids in Pakistan.

A joint study conducted recently by UNAids and the Aga Khan Univeristy in Karachi reported that 80% of known cases in Pakistan involved people who had been deported from the Gulf states for having Aids.

Lack of detection "may cause an Aids epidemic in Pakistan, especially among high-risk population sub-groups such as injecting drug users, sex workers and unsuspecting spouses," says Mr Saeed.

Specialist treatment

The WHO is trying to implement a plan under which prevention and treatment programmes would go hand in hand.

The treatment centres offer not only treatment, but also counselling sessions for patients and relatives.

"Unfortunately, prevention programmes take time to produce results and high risk sexual behaviour is not easily changed into safer practices," Mr Saeed says.

But of late there has been evidence that some sufferers are breaking their silence.

"An increasing number of patients are approaching us because they know they can receive specialist treatment which can prolong their lives," says Dr Yasin Malik, who is in charge of an anti-retroviral treatment centre in the north-western city of Peshawar.

Aids was detected in Pakistan in 1987 and has been spreading since.

The scale of the country's problem is dwarfed, however, by that in neighbouring India, which has more people living with HIV than any other country in the world.

According to UNAids, 5.7 million people had been infected there by the end of 2005.