Presentation for RFET AGM
Wednesday 5 November 2003 at 7.15 pm
Elvet Riverside Staff Common Room (New Elvet, Durham)
By: Owen Manda
A PRESENTATION ON HIV/AIDS AWARENESS, PEOPLE’S ATTITUDES, PERCEPTIONS AND BEHAVIOUR AND THE DISCRIMINATION FACED BY PEOPLE LIVING WITH THE VIRUS. THIS PRESENTATION IS INFLUENCED BY THE RESEARCH ON HIV/AIDS AND STIGMA WHICH I DID AS PART OF THE BA (HONS) I COMPLETED A YEAR AGO AT VISTA UNIVERSITY (SOUTH AFRICA)
Without any doubt AIDS as a disease has been mapped onto stigma in the form of intense devaluation, discredit, dishonour and degradation. AIDS has almost become synonymous with profound stigma — a connection which it seems almost impossible to avoid.
Most obviously people avoid those who pose a threat to their health and safety. To the extent that AIDS is contagious, fatal and presently incurable, many people hesitate to interact with individuals who are known to be to be HIV positive or have AIDS, despite assurances by the medical community that HIV is not transmitted by casual contact.
In line with this year’s theme of world AIDS day (stigma and discrimination), I feel obliged if not tempted to touch a little bit on stigma and discrimination.
From the moment scientists identified HIV and AIDS, social responses of fear, denial, stigma and discrimination have accompanied the epidemic. Discrimination has spread rapidly, fuelling anxiety and prejudice against the groups most affected, as well as those living with HIV or AIDS. It goes without saying that HIV and AIDS are as much about social phenomena as they are about biological and medical concerns. Across the world the global epidemic of HIV/AIDS has shown itself capable of triggering responses of compassion, solidarity and support, bringing out the best in people, their families and communities. But the disease is also associated with stigma, repression and discrimination, as individuals affected (or believed to be affected) by HIV have been rejected by their families, their loved ones and their communities. This rejection holds as true in the rich countries of the north as it does in the poorer countries of the south.
Stigma is a powerful tool of social control. Stigma can be used to marginalise, exclude and exercise power over individuals who show certain characteristics. While the societal rejection of certain social groups (e.g. 'homosexuals, injecting drug users, and sex workers') may predate HIV/AIDS, the disease has, in many cases, reinforced this stigma. By blaming certain individuals or groups, society can excuse itself from the responsibility of caring for and looking after such populations. This is seen not only in the manner in which 'outsider' groups are often blamed for bringing HIV into a country, but also in how such groups are denied access to the services and treatment they need.
One of the cases that spring to my mind is that in December 1998, Gugu Dhlamini was stoned and beaten to death by neighbours in her township near Durban, South Africa, after speaking out openly on world AIDS day about her HIV status.
Without giving a lecture on stigma and discrimination, I think it also important to mention the kind of progress that we have made as South Africans to try and fight against the scourge of AIDS.
People living with HIV/Aids around South Africa are anxiously waiting to see whether Cabinet will approve an operational plan to introduce antiretroviral drugs into the public health sector. Cabinet is expected to decide on the plan as early as Wednesday (today) — the Department of Health finally made ready all the necessary documents late last week. The plan was due to be tabled at the last Cabinet meeting almost two weeks ago. But some last-minute queries, arising from a meeting of the minister of health and the task team of provincial health ministers that drew up the plan, delayed the process.
The immediate priority is to prepare health facilities and provide training for health workers, the vast majority of whom have had absolutely no training in antiretroviral treatment.
It is clear that the South African government is now moving in the right direction in an attempt to provide treatment, and it is to be hoped that soon almost all South Africans will be having access to treatment facilities.
A question in my mind is: does that simply means that we have solved the problem of HIV/AIDS by providing antiretroviral drugs? I don’t think so, the problem is still huge. What we are experiencing are socio-economic problems: poverty, unemployment, crime, gender inequality, illiteracy and misconceptions (myth). There is another problem of the majority of young people (16-23 and 24-35), who are the most infected group; their behavioural patterns expose them to risks of contracting the virus.
The greatest challenge we are faced with is to induce behaviour change. I see this as a major challenge facing the public health systems, AIDS activists and social scientists. One of the most frequently asked questions is: do social scientists bring any special talents to the AIDS prevention challenge? My answer is that social scientists will have to devise interventions, evaluate them, and keep refining them until the anticipated group behaviour changes have occurred. Social scientists will have to derive principles of successful intervention that are applicable across a wide range of social classes, racial groups and subcultures. This is a formidable challenge.
Finally, there is the question of research on the protection of young people and future generations. There is a need for more research on specific socio-economic contexts, in particular an understanding of gender differences in the socialisation of young people into sexuality. There is also a need to generate more knowledge on young men and women’s perceptions of sexuality and gender relations. Problems of communication about sexuality and within sexual negotiation need to be addressed. It is important to understand the factors and processes that constrain or enhance communication and dialogue among young people. In this regard, promotion of sexual reproductive health (SRH) education for both in and out-of-school youth is important.
As condoms still provide the most useful means of preventing HIV transmission, research is needed to identify non-stereotypical images and messages that might appeal to men and women and encourage increased condom use. There is also a need to find ways to strengthen women’s sexual negotiations skills.
It is vital that research focuses not only on the way in which dominant norms place young peoples’ sexual health at risk, but also on the ways in which particular young people resist these norms, sometimes leading to alternative and less risky sexual behaviours and practices.
I hope that one day we will be able to find answers to these problems. I believe that the academic knowledge I am acquiring here in Durham will empower me with research skills and techniques and make me better able to make a positive contribution in solving these problems.
I am very optimistic about the future of our country and believe that we will defeat AIDS as we have defeated the evil apartheid system.