POSITIVE LIVING, STIGMA AND DISCRIMINATION

8/7/2019 POSITIVE LIVING, STIGMA AND DISCRIMINATION.

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POSITIVE LIVING, STIGMA

AND DISCRIMINATION.

Dr stephen Watiti,

Mildmay Uganda.

256 772 638466

[email protected]

19/04/2011


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POSITIVE LIVING Accepting the diagnosis that one is HIV +ve, or

coming to terms with that fact should come first.

It is about a positive attitude toward onessituation; the attitude that there are a lot of

things I can do to make my situation better and I

am willing to take up the challenge.

Once these two issues are resolved then we can

talk of unpacking the whole concept of positive

living


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POSITIVE LIVING contd The TASO philosophy of positive living is well articulated

in their brochures and includesSeeking counselling & promptmedical treatment including adherence to ART

Practicing safer sex Carrying on with a normal life style e.g continuing to earn an income

Regular taking of a balanced diet

Use of Basic Care package commonly associated with PSI andavoiding harmful practices


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STIGMA, DENIAL &

DISCRIMINATION Stigma:

Stigma can be defined as anything that

significantly discredits an individual or agroup of people in the eyes of others. It is asign of shame.

Denial:

Denial is a state that something is not true ordoes not exist. Denial usually comes as away people respond to being stigmatised


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STIGMA, DENIAL &

DISCRIMINATION (Contd) Discrimination occurs when a distinction is made

against a person that results in his or her beingtreated unfairly and unjustly on the basis of theirbelonging,or being perceived to belong,to aparticular group.

It can be an act of either silence or exclusion ofPLHIV from our normal agenda. This limits our

ability to get involved in their lives in a meaningfulway.

Discrimination is stigma put into action or acted

out


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STIGMA, DENIAL &

DISCRIMINATION (Contd) It follows that where there is a lot of stigma there

will also be a lot of denial and if there is denial it

complicates the fight against the spread of HIVin the population.

PLHIV will want to make others believe that they

are not infected and this has serious

implications in PMTCT, Discordance, Condomuse etc.


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SOURCES OF STIGMAThe perceptions and metaphors;

AIDS as Death

AIDS as Crime AIDS as Horror

AIDS as War

AIDS being linked to socially marginalisedgroups - commercial sex workers,MSM,Intravenous Drug Users e.t.c.


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FORMSOF

STIGMA

Self Stigma

Family Stigma

Stigmatisation of Children

Stigmatisation in Work places

Stigmatisation in Religious institutions

Stigmatisation in Health care facilities


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SELF STIGMA This is also called felt stigma or internal stigma. It is the way

you feel about yourself especially if you feel ashamed that

you are HIV +ve.

It affects the way people come to see themselves

They can isolate themselves.

Get depressed, refuse medicine & food, refuse to

look for help (can finally die) Self condemnation

Lack of self esteem


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FAMILY STIGMA Hidding the patient from neighbours, friends &

relatives

Fear to be seen with the patient

Can abandon a PLHIV in hospital or insist thathe/she travels aloneeven when he/she is too sick,

some patients die alone!

May want him/her dead quickly so as to get rid ofsource of shame, this might result in lack of care orproper treatment


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FAMILY STIGMA (Contd) Women might be chased with their children as

they are perceived as the ones who broughtAIDS in the family

Other patients are sent to the village to die

F

orcin

g peopl

eto writ

ewills so as to hav

ea wayof sharing property

Sharing ones HIV status can result in seriousmisunderstanding, that may end up in

divorce;family breaks up at a time when they


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STIGMATISATION OF

CHILDREN

Children not taken to school if discovered to be

HIV+ve

Some children discriminated by other children;thiscan cause children to run out of school or fail to

concentrate

Children unable to explain to their friends why theirparents are sickly or what their parents died of.

(need to be helped).


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STIGMATISATION OF

CHILDREN (Contd)

Others confused because they dont believe that

their parents are bad people (yet HIV is associated

with unacceptable behaviours among adults). Denying them treatment when sick (its a waste of

time)

Children on ART have poor adherence unless

disclosure and proper counselling have been done Children lack role models so they fear disclosure

and so take risks which can be fatal in the long run


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STIGMA IN WORKPLACES

Terminate from employment

Refuse to employ

Ostracized by colleagues if person is open abouthis/her HIV status.

Pre-employment screening (HIV testing)

Denying person friendship,handshake,hugs.


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STIGMA IN RELIGIOUS INST.

Ignoring the existance of AIDS and encouraging belief that thiscant happen to us

During preaching and public address, insensitive utterances e.gavoid immorality so that you dont die of HIV/AIDS with no mentionof other modes of HIV transmission (MTCT, blood transfusion,accident victims e.t.c.)

PLHIV are discriminated against e.g. cant preach, marry or be

ordained in ministry.

Restrictions of persons right to anonymity and confidentiality.e.gcompulsory testing and revealing of sero-status.


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STIGMA IN HEALTH CARE

FACILITIES

Denying patients care and support

With holding life saving drugs and treatment

Stigmatisation of health care providers that are HIV+ve

Failure to include ARVs on the list of essential drugs

E.T.C.


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STIGMA AND ART

ART involves not only availability of ARVs,butexpensive laboratory tests, which the patient maynot be able to afford and yet they cant make a loud

appeal for help!

Involves sharing HIV status with your family in orderto explain why you are taking drugs. Adherence andcompliance will always be poor in the face of stigma

Side effects of drugs e.g. nausea and vomiting,skinchanges,body fat redistribution,darkening of nails, etc.


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STIGMA AND ART (Contd)

People that are unwilling to share their HIV status wait until itstoo late and possibly die(this has often been true even with thosewho are economically able to buy the drugs)

Others have privately treated themselves and this has resulted inother serious conditions which could have been avoided (this isespecially true for health care providers)

Others have opted to privately have themselves treated andleave their spouses to die either for fear of telling them orrealising the money cannot go round.


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CONCLUSION

My personal experience is that the more youunderstand issues regarding stigma the more

you are empowered and equipped to manage it It is especially important for people who are HIV

negative or those who would like to think theyare, care givers, activists, and all those involvedin the battle against HIV/AIDS to understand theimplication of stigma in prevention, care, supportand treatment.

HIV/AIDS and the related stigma, thrive on fear,ignorance and secrecy. The best weapon

against these is information.

Documents

POSITIVE LIVING, STIGMA AND DISCRIMINATION