More than forty years after the start of the AIDS epidemic, people living with the disease in Africa face a stigma that is still very present, despite the work of associations to help them. On the occasion of World AIDS Day, this Thursday, December 1, an overview of reflections on discrimination, which has become an obstacle to the response to HIV.
Isolation, judgment, verbal and physical aggression, hurtful attitudes towards people living with HIV have not really changed since the 1980s. The reason: this received idea that HIV and AIDS rhyme with immoral sexual behavior. This message is sometimes conveyed by religious leaders on the continent.
HIV remains a taboo” associated with immorality »
In Kenya, self-proclaimed prophet David Owuor promised again last week to heal HIV-positive people through prayer. A speech that seduces in this conservative country where more than 80% of the population is Christian.
“ In the collective imagination, HIV is associated with immorality and sex outside marriage. People consider it a taboo, they are not educated enoughsays Nelson Otwoma, CEO of Nephak, a national empowerment network for people living with HIV in Nairobi. Even health professionals make false judgments. They consider, for example, that a young girl or a young boy may not be old enough to have HIV. People lose motivation to seek treatment and refuse treatment for fear of being stigmatized “, he says.
Discrimination by family
However, examples abound of people who have contracted HIV outside of any sexual relationship. Oscar Ewaa contracted it through blood contamination when his late aunt intentionally infected him.
” I was only 7 years oldhe recalls. She cut me to bleed, then cut herself. She wanted to infect me. Because shortly after she adopted me, her child, who was my age, died. Her husband therefore made the amalgam and accused me of being responsible for the death of his child. »
When Oscar tested positive for HIV, that’s where the discrimination started. ” My family rejected me, I had to scavenge to eat, I slept with the chickens in the kitchen, I ended up begging in the streets. In Uganda, once you are HIV positive, it is difficult to find a job. »
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More than a third of people living with HIV unemployed because of discrimination
According to the Global Stigma Index Survey, conducted by the Global Network of People Living with HIV (GNP+)more than a third of people living with the virus in countries like the Democratic Republic of Congo do not work because of employment discrimination.
” Stigma and discrimination touch almost every area of life for people living with HIV. They interfere with their access to treatment, their basic rights, employment, or even their interactions with their peers “, explains Omar Syarif, coordinator of the index within the GNP+.
One of the major causes is social norms and the influence of religious beliefs.
Lack of funding against prejudice
In the Lango sub-region in northern Uganda, Oscar launched an awareness campaign to reach young people: some had stopped their treatment under pressure from their pastors.
” We buried four young people with HIV. They died because they believed in divine healing, so I decided to start this campaign to encourage them to take their medicine with the same fervor with which they prayed to God. »
” The problem is that no one funds programs to fight this stigmadeplores Nelson Otwoma, CEO of Nephak. We fund antiretroviral treatment, but no donor gives resources for awareness programs so that communities know how to avoid stigma. »
self-stigma
The main populations victimized by stigma are sex workers, drug addicts and unmarried women: all of these populations are blamed for their lifestyle.
For Omar Syarif, of GNP+, to overcome the bad looks of others, you must first work on yourself: “ Self-stigma remains an important phenomenon. Because some people with HIV are ashamed of themselves and consider themselves unworthy “, he says.
Omar is also HIV positive and has been living with HIV for 17 years:
” To overcome some of my personal issues related to stigma and discrimination, I first had to convince myself that I had the same rights as everyone else. It means not being ashamed of my HIV status. Today, I take my treatment, I have a family and I can talk openly with my relatives about my HIV status. Once you have made peace with yourself, then it will be easier for you to overcome the stigma that comes from others. »
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Rwanda continues its good management of AIDS and wants to achieve WHO objectives
In Rwanda, UNAIDS estimated the number of deaths linked to the disease in the country in 2021 at 2,400, a figure down 84% since 2004. The World Health Organization also cites the country as the one of the nine African countries on track to achieve the objectives of combating the epidemic by 2025: according to figures from UNAIDS, Rwanda is now at 94% of HIV-positive people who know their status, 93% of them are monitored and 91% no longer have a detectable viral load, and now wants to reach 95% for the three criteria.
With our correspondent in Kigali, Lucie Mouillaud
At the public health center in the Remera district in the capital Kigali, nurse Ruvuzandekwe Phanuel consults the file of one of his patients in the consultation room: “ They are asked during the consultation about their weight, the results of the HIV viral load test, and then they go to the pharmacy, where they receive advice on correct adherence to medication. »
Objective: to ensure proper follow-up of the treatment and regularly check the evolution of the virus and personalized support according to the risk presented by the patient: “ It can be every month, or every three or six months. Today I saw the patient after a month, because her viral load is still detectable. »
In the health center, about 20 new positive cases are detected every month, with more and more tests targeting those at risk and linked to HIV-positive patients. Leonidas Batamugira, director of the establishment: ” Our goal is to achieve the ambitions of the three 95:95 % diagnosed, 95 % of people diagnosed on treatment and 95 % of people on treatment who no longer have a viral load. »
According to figures from UNAIDS, Rwanda is now at 94% of HIV-positive people who know their status, 93% of them are followed and 91% no longer have a detectable viral load.
Report in a health center in Kigali, which continues its good management of AIDS and wants to achieve the objectives of the WHO