AIDS and Shame
Introduction
It
is unfortunate that after more than 25 years since the discovery of the initial
cases of AIDS the stigma that is associated with the disease has remained one
of the most significant hindrances to public action. Regardless of the various
awareness campaigns all over the world, including Africa, about the epidemic,
people have remained adamant to test whether or not they have the virus. Additionally,
for some of those who are diagnosed with the virus, they are still reluctant to
seek medical treatment (Pieter, 72). There is still fear of the stigma and the
social disgrace that has historically been associated with the disease.
Different leaders in Africa has argued that a huge step has been made towards
addressing the issue of shame that impends testing and seeking treatment for
those infected with the disease. Some have suggested that their nations have
seen a major achievement towards this end. However, this argument is unfounded
based on the studies that have carried out even by international researchers that
have revealed a major problem in as far as testing and treatment of the disease
(Hunter, 15). This paper borrows from Sizwe's Test by Jonny Steinberg in
proving the fact that regardless of the argument of most African leaders that
huge steps have been made towards addressing the issue of Aids and shame, there
remains a huge problem in that many people have continued to refuse testing and
treatment.
According
to Pieter (2006), various efforts are argued to have borne fruits in most
African countries in as far as AIDS is concerned. Initiatives to create
awareness have been launched in these countries, including some with support
from the international community. The various initiatives as well as campaigns
that have been used in the efforts to curb the spreading of the epidemic in
Africa have reported positive results. Some of the campaigns and initiatives
like the Abstinence be faithful, use a condom or ABC campaign have been in
place for a long time. Research into these initiatives and others continue to
reveal significant improvement in the creation of awareness among the African
people regarding the presence of the disease and the importance of testing and
treatment (Kelly and Birdsall, 1583).
However,
regardless of these supposedly positive efforts, AIDS remains a major problem
in the continent because of the prevalence of stigma and the shame associated
with the disease. People in most African countries are still not interested in
knowing about the epidemic. Researchers have noted various cases of people who
have refused to test or seek treatment in case they are found to have the virus
(Mbonu, van den Borne and De Vries, 3). The shame that is associated with the
diseases has had detrimental effects on the efforts to take fast and effective
actions towards addressing the epidemic. According to the United Nations
Secretary General, Ban Ki Moon, “Stigma remains the single most important
barrier to public action. It is a main reason why too many people are afraid to
see a doctor to determine whether they have the disease, or to seek treatment
if so. It helps make AIDS the silent killer, because people fear the social
disgrace of speaking about it, or taking easily available precautions. Stigma
is a chief reason why the AIDS epidemic continues to devastate societies around
the world” (Lengauer, Altmann, Thielen
and Kaiser, 2010:67).
Regardless
of any argument that significant steps have been made to stop discrimination of
the people diagnosed with AIDS, discrimination is still prevalent in most
African communities. Discrimination against those infected by AIDS refers to the
situation where the individual is discriminated against, treated badly or
oppressed due to their real or perceived HIV status. Stigma and discrimination
attached to AIDS is the prejudice, abuse, negative attitudes, and maltreatment
that are directed to those suffering from the disease (HIV/AIDS Policy Fact
Sheet, 2). According to Iwelunmor and Airhihenbuwa (2012) there are various
cases of individuals suffering from the disease being rejected by their families,
peers and the society in general. Some have experienced poor treatment in
education, healthcare and employment. Individuals have been fired from their
employment, removed from their homes, and denied access to health care and
social services because of their HIV status. Others have had their businesses
affected just because they are diagnosed with the disease. This has been as a
result of the shame that is associated with the disease (Hunter, 36).
In
some African communities, a person suffering from the diseases is feared
because of the fear of infecting others. Some living with the disease are quarantined
in fear of infecting others. Stigma and discrimination associated with the
disease exists in every part of the continent regardless the fact that they
manifest themselves in varying magnitudes. They manifest themselves in a
different way across communities, religious groups and individuals. They happen
alongside other kinds of stigma and discrimination like homophobia, racism, or
misogyny (Mark, 561). They can even be directed to the people who are known to
involve in what are taken as socially objectionable behaviors such as drug use
and prostitution. In most of the African nations, AIDS has been associated with
immorality and other negative social behaviors. As such, people fear to test in
case they test positive and are discriminated against by their society (Mbonu,
van den Borne and De Vries, 6).
Fear
of infection exists which is coupled with the negative view of the people who
are infected. There are number of factors that have been known to contribute to
the stigma and shame that are attached to AIDS. One of the reasons is that the
disease is life-threatening and this makes individuals to react to it in a
negative manner. Infection with the
disease is associated with immorality and other socially unacceptable behaviors
such as homosexuality, prostitution, drug abuse and promiscuity. Such behaviors
are already shameful and stigmatized in the society. Most of the people who are
infected with the disease are known to acquire it through sexual acts, which by
themselves have a moral baggage (Hunter, 128).
In
most African communities, individuals have also been misinformed in as far as
the disease is concerned. Religious as well as moral beliefs in the society have
caused people to belief that AIDS is as a result of moral fault that deserves
punishment. The fact that this disease has appeared in the modern period also
makes the stigma attached to it even worse. The fear and shame that was
associated with the epidemic as it emerged in the 1980s is still fresh in the
minds of many people (Mark, 561). From the time it emerged, a serious of strong
and powerful images were utilized to justify and reinforce stigmatization and
shame. Such images include: as a punishment for immorality and other antisocial
behaviors, as a crime related to the guilty and innocent victims, as warfare in
relation to a virus that had to be fought, as revulsion in which the infected
should be feared and demonized, and as otherness in which is an suffering for
the people set apart to suffer (Mbonu, van den Borne and De Vries, 8).
Shame
and stigmatization has kept many people in the African continent from getting
tested and treated for the disease, regardless of most having the knowledge of
treatment programs such as antiretrovirals. A good illustration of this
situation is given by Steinberg in Sizwe’s
Test. Sizwe is aware of the availability and accessibility of ARVs, and
even urges some of his people to get tested for the virus. He is also one of the most people in the
continent who are at risk of the virus because of having unprotected sex with
many partners. However, just like many other individuals in his society, he
refuses to test for the virus, although he is ready to settle down in marriage
(Steinberg, 16-19).
Various
factors are playing a major role in most parts of the continent in the refusal
to get tested and treated for the virus. Lack of privacy has emerged as one of
the reasons for this problem. The lack of privacy coupled with low levels of
literacy and a lack of understanding are contributing a great deal to the
failure to seek intervention for the disease. Testing positive for HIV in such
communities is a huge shame and all members of the community will know. Knowing
one’s HIV status, in case it is positive is opening the door to negative
attitudes, stigmatization and discrimination in such as community. People will
always speak about those infected in a negative manner. This kind of behavior
discourages people from getting tested and seeking treatment in case they test
positive for HIV (Steinberg, 22-24).
Besides
the nature of the society, testing positive for HIV is a source of weakness and
vulnerability. For individuals, who hold a respectable place in the society,
HIV is the last problem they want to face. From this perspective, those individuals would
rather stay without knowing their status or even fail to seek treatment for
fear that their weakness or vulnerability will be exposed. Most of the people
who are aware of their status will keep it a secret because they are afraid of
the negative consequences of exposure. For those who are not married this is
especially a major problem because no one will be prepared to marry a sick
person. Some people get into marriage without testing for the disease because
of the fear of knowing that they are positive and risking rejection (Kelly and
Birdsall, 1585).
Besides
this, most people in the community view sickness as bewitchment or as a result
of some evil forces. This is a major factor behind the lack of testing and
treatment. Sickness is seen as evil powers sent to the individuals by the
ancestors or other people wishing them ill. As a result, the knowledge that one
is sick from such an evil disease is something to be afraid of. This is
especially a major problem given the fact that it interferes with man’s ability
to procreate. Procreation in the African community is one of the most important
aspects of the society. Any attack on this ability is viewed negatively and is
normally a source of shame. This is especially a great problem in poverty
stricken areas where their hope rests in the ability to reproduce (Kelly and
Birdsall, 1587).
Summary
Iwelunmor
and Airhihenbuwa (2012) posit that The kind of life that exists in the African
continent strengthens stigma and shame associated with HIV/AIDS. Most of the
communities in Africa live a communal life. This is an important element of the
society because of the social support especially in care for the sick. However,
as far as AIDS is concerned, this has played negatively especially in the
efforts to fight the scourge. Stigma is used by communities and individuals in
this setting, as well as in cultures were communal life exists. Stigmatization forms
part of a conservative re-assertion of power associations, poverty, or moral power
that rests on the capacity to control sexuality. Due to the fact that the
community labels people living with AIDS as the “other”, individuals in the
community seeks to secure the social structures solidarity and safety by
casting out reprobates or re-affirming societal values. People living with AIDS
are regarded as outcasts whoa are no longer able to contribute to the
development and wellbeing of the community. For example, surveys have showed
that some women fail to disclose their HIV status as they are afraid of not
being able to participate in the socio-cultural element of food preparation
because food is considered an element of support and acceptance. The society
has seen people refuse to buy or eat food from women who are diagnosed with the
virus (Mbonu, van den Borne and De Vries, 10-11).
Studies
have also shown stigmatization of family members of an individual living with
the disease or one that has died from AIDS. For this reason, people with the
disease are discouraged by members of their families to remain silent about
their condition to avoid shame or social rejection. In some cases getting
assistance from the government too enhances a view of difference from the rest
of the community given the assumption that there are only people living with
AIDS who are assisted by the government in a community that is poor and in need
for support (Mbonu, van den Borne and De Vries, 13).
Stigma
is a major hindrance to efforts to address the issue of HIV/AIDS. This is
because it supports denial and secrecy, important factors in catalyzing
transmission of the virus. Regardless of the argument that response to people
living with the disease varies, with some individuals being able to receive
adequate support, the stigma or shame associated with the disease affects
seeking testing, receiving care once diagnosed, quality of care provided to
those with the virus, and lastly the negative perception and treatment of people
living with the disease by their families and communities, including partners. It
also isolates those who are sick from their communities and become detrimental
to their wellbeing. Research into
HIV-related stigma in Africa has been going on for a long time, which is
informing policies and intervention programs. However, it has been recognized
that effective treatment and care interventions necessitate a clear understanding
of the cultural context within which stigma exists (Mbonu, van den Borne and De
Vries, 14).
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From
AIDS Among Women In South Africa." Death Studies 36.2 (2012):
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