04.DEC.09

by the The Caribbean HIV&AIDS Alliance (CHAA)

Stigma and discrimination are two words often faced by people who are HIV positive. In most cases, these harsh words when used in the HIV context talks about the unfairness, inequality and or injustice directed towards people living with HIV and AIDS. This discrimination leads to HIV positive people being denied opportunities because of their status. As a result, many persons are reluctant to access HIV testing, care and treatment, this further obstruct efforts to address the AIDS epidemic across the Caribbean.{{more}}

Negative responses and attitudes towards persons living with HIV comes from limited knowledge and misconceptions about HIV and AIDS, particularly the causes and ways of transmission. A 2007 CAREC Survey done in St. Kitts and Nevis reported that between 1- 5 percent of the population within the age group 15-49 years expressed accepting attitudes towards people living with HIV and AIDS. When placed in hypothetical scenarios the individuals appeared to be compassionate and willing to care for HIV-positive family members; they were also willing to allow an HIV-positive students, teachers or co-workers to conduct their normal school/work activities however there was a low willingness for food-related contact.

An outreach worker at the Caribbean HIV & AIDS Alliance (CHAA) stated that people still see an HIV positive person as someone ‘who looks skinny and have sores on their skin’. The outreach worker who sees clients that are HIV positive gives this account:

“A client of mine who is HIV positive got unto a bus and sat next to someone. The person ‘jammed’ herself against the window to avoid touching my client because she knew my client was HIV positive.”

In recent years through the efforts of government agencies, local non-governmental organisations and regional organisations such as CHAA there has been an increase in HIV/AIDS awareness in various Caribbean islands. However, there is a lot more that needs to be done to break the stigma and discrimination barriers against persons living with HIV, most at-risk populations and marginalised community groups accessing HIV/AIDS services.

Negative reaction by a community to someone living with HIV and AIDS can have a damaging effect on that person’s life. Discrimination in these settings is expressed in a variety of ways including persons and/or their families being ostracised, loss of jobs, evicted or verbally and physically abused. Following are some examples given by community members who prefer to remain anonymous:

“I lost my job because I’m HIV positive. They (managers) won’t come to you and say that it’s because of your status. They’ll say, ‘business is slow’ but in your heart you know that it is because you have HIV.”

“This particular church removed a member of the worship team because her husband had died of AIDS. She went to another church but they warned the pastor of that church to be wary of her.”

A study done in St Kitts and Nevis found that whether personal, professional, or just everyday talk, nothing is taboo in terms of discussion and disclosure. In a small community context, it is seen as normal to talk about other people’s “business”. However, the culture of small talk in St. Kitts and Nevis has had an impact on whether or not people feel comfortable going for services such as HIV testing, care and treatment. One HIV and AIDS supporter puts it this way, “”The dilemma we face is how to maintain privacy and confidentiality in a nosey society, skilled at story-telling.” Persons who know they are HIV positive keep quiet about their status to avoid being stigmatised and discriminated against.

A holistic approach is needed to deal with stigma and discrimination. The fear and prejudice that lie at the core of these issues need to be dealt with at the community and national levels. It requires action on the part of individuals, decision-makers, policy makers, and health care workers to not only be made aware of the negative effects of stigma and discrimination but to join in creating an enabling environment where persons living with HIV and AIDS are treated fairly and equally as compared with others in society. Education and prevention continue to be critical tools in fighting stigma and discrimination. Supporters at the community level are needed to raise the real understanding of HIV and remove misconceptions that can lead to stigmatising actions.