Do not let stigma kill you
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AND THE WINNERS ARE . . . Miss ARV Laiza Zvakurumbira (centre) is flanked by her two princesses Rumbidzai Masvaure and Joyce Hungwe

Catherine Mwauyakufa
Stigma is the greatest threat in the national response to HIV. It prevents individuals from getting tested for HIV, seeking medical care, disclosing to partners thereby failing to stick to treatment requirements and follow-up.Fear of social abandonment and losing intimate partners prevents many with HIV from sharing the diagnosis with their loved ones and sexual partners.

Stigma has become a major reason why the HIV epidemic continues to spread and millions of people are getting infected and dying every year.

Take an example of a pregnant mother who gets tested during ante-natal clinic and tests HIV positive. She decides to keep her status to herself not even disclosing to her partner for fear of being divorced or even be blamed for being the source of infection.

Dr Angela Mushavi, the National PMTCT, Paediatric Care and Treatment Co-ordinator in the Ministry of Health and Child Care, said stigma remains a barrier to seeking treatment.

“Pregnant women who test HIV positive find it difficult to disclose to their partners for fear of being abandoned or even blamed for being the sources of infection. So for such a mother, seeking treatment becomes a challenge. Pregnant mothers are therefore urged to bring their partners to ante-natal clinic so that they are tested together,” said Dr Mushavi.

Since stigma remains a barrier to seeking treatment and living openly with the virus, people living with HIV launched a tool to measure the effects of stigma and how this could be overcome.

The Stigma Index provides a tool that measures and detects changing trends in relation to stigma and discrimination as experienced by people living with HIV.

The index is a joint initiative of organisations who have worked together since 2004 to develop this survey. These include: The Global Network of People Living with HIV and Aids; The International Community of Women Living with HIV and Aids; The International Planned Parenthood Federation; and the Joint United Nations Programme on HIV and Aids.

Zimbabwe launched the Stigma Index in March 2013 whose national co-ordinator is Mr Tonderai Chiduku, a member of Zimbabwe National Network of People Living with HIV.

Mr Chiduku has lived with the virus from the early 90s and faced the barrage of stigma together with the late great veterans Auxillia Chimusoro and Lynde Francis.

Mr Chiduku is best placed to evaluate where we are as a country as stigma issues are concerned. Mr Chiduku said acceptance towards people living with HIV and Aids is still far from being acceptable. He said that it stood at around 39 percent to 40 percent.

“Zimbabwe is targeting to increase the acceptance levels to 60 percent among men and 75 percent among women by 2015. People living with HIV are at the centre of the process as both interviewers and interviewees. The index is designed to increase the understanding of how stigma and discrimination is experienced by people living with HIV.

“The data gained can then be used by the national implementing partners to shape future programmatic interventions and policy change,” said Mr Chiduku in Harare last week at the Zimbabwe National Aids Strategic Plan (2011-2015) mid-term review meeting.

Why is HIV viewed in such a strong way compared to other diseases which are also life-threatening like cancer or diabetes. Many societies already stigmatise promiscuity, prostitution, homosexuality and drug addiction and HIV was and is still associated with such behaviours.

Most people become infected with HIV through sex, which often carries moral blame. HIV is said to be a result of personal irresponsibility by most people.

There is a lot of inaccurate information about how HIV is transmitted, creating irrational behaviour and misperceptions of personal risk.
Religious or moral beliefs lead some people to believe that being infected with HIV is the result of moral fault “deviant sex” that deserves to be punished.

The effects of anti-retroviral therapy on people’s physical appearance can result in forced disclosure and discrimination based on appearance.

This is true on clients who used stavudine based regimes which tended to deform the person taking the medication. Clients on stavudine ended up with thin faces, thinned out legs, ears sticking out and at times uneven deposit of fat on the tummy and breasts. Stavudine is being phased out after its side effects outweighed the usefulness.

ZNNP+ last month sought to overcome stigma by showing that despite being HIV positive, they could still be involved in all activities that HIV negative people do. The Midlands chapter literally walked over stigma as they held the first Midlands Mr and Ms ARVs ‘beauty’ pageant.

ZNNP+ acting executive director Mr Spencer Gundu, who was the guest of honour, applauded the chapter for their aim to reach the three zeroes by 2015 through zero stigma and discrimination.

“Firstly, let me take this opportunity to congratulate Midlands for organising such an amazing event to fight stigma. HIV is a condition that was associated with a lot of fear, stigma as well as labelling in the early eighties. In 2008, the ZNNP+ membership came up with a gleaming initiative to tackle the rising stigma and discrimination which had become a part of their daily challenge.

They saw it fit to gather evidence for their communities disclosing their HIV status,” said Mr Gundu.
“In a bid to address stigma and discrimination ZNNP+ embarked on conducting awareness campaigns in the form of beauty contests. The objective being mainly to encourage others to seek VCT services early and also to encourage people to disclose their status to their partners to avoid new infections and re-infections.

“Our beauty contests are different from the Ms Zimbabwe pageant where they concentrate more on beauty, the Ms and Mr ARV focuses more on treatment adherence, disclosure and confidence of participants towards their HIV status,” said Mr Gundu.

Mr Gundu said his organisation sought to have people recently testing HIV positive know that they have friends and can lean on ZNNP+.
“We cannot tell what happens to us in life. But we can decide what happens within us, how we take it, what we do with it and that is what really counts in the end. I urge you here today, to join hands, rise and fight against stigma to reduce the spread of HIV and reduce deaths due to Aids. Live and let live!

“Let’s support all those who are infected and affected. Our relatives, friends and children who have suffered, and those who are still suffering need our support, love and care. Let’s give them love. Pane asingadi kudiwa here asimuke timuone, naizvozvo ngative neumwe pahondo iyi yekurwisa kuparadzirwa kweutachiona,” he said.

The pageant’s theme was “Getting to zero through modelling”.
Mr Gundu said that work and lives continued even after one tested HIV positive.
“Do we neglect anyone who tests HIV positive? Do we no longer associate with them, do we feel scared of being with them or even sending them away from work, that is the big question here? The answer is personal choices in each one but remember the infected person still retains their skills,” he added.

Mr Gundu said that stress had a negative influence as it tended to make one ill.
“Stigmatised people are stressed and a person stressed often result in feelings of depression, grief, feelings of loss, loneliness and anxiety. These emotions have a very strong effect on the body and can even worsen immune deficiency, putting the individual at a greater risk of developing life threatening infections.

“This is where beauty contests come in, and it has shown to be very useful in helping such individuals cope and overcome these emotional aspects of the illness. Furthermore, this also helps others to accept their status and move on with life. HIV is a condition which is manageable only if one gets to test for their HIV status, accept results and get on with life.

“Today, let’s all agree to fight stigma and stop the further spread of HIV. Nyaya yeHIV inotoda kuitwa mukomberanwa chuma chomuzukuru.

“I would like to urge all of you present here, government departments, NGOs, funding partners, the media, private sector and other partnerships to continue upholding your commitment in the fight against HIV. That way, we will achieve the three zeros by 2015,” said Mr Gundu

“Above all, people living with HIV in particular, have a unique role to play as witnessed here in fighting stigma, promoting appropriate care and support, in providing insights into adherence issues, and in identifying their education and information needs.

“In short, people living HIV must be recognised as partners in the response. I urge you not to lose the spirit. Keep fighting and remember that ‘Hope is Vital’. I would also want you to ask yourself this question, ‘Am I Doing Something?”

The winners in the pageant had no age limit and it was all smiles as the Mr and Mrs ARVs were crowned. You could also be one living in denial due to stigma. Get out of the shell seek a support group and be empowered by those who like Mr Chiduku lived in the era where testing HIV positive was a death sentence but still opened up and helped save lives.

Today the stigma index is still underway and is a tool to measure where the nation stands as stigma is concerned. I know my status, do you know yours? Do not let stigma kill you, get tested. Get the stigma blocker out of your ear!

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