REDUCING HIV/AIDS STIGMA & DISCRMINATION IN GHANA
The term stigma goes back to the days of Greek civilization when it refers to a tattoo mark branded on an individual skin for wrong doing. The physical mark publicly identified the blemished individual as one to be avoided. So stigma is prejudice and discrimination against a set of people who are regarded by others as being flawed, incapable, morally degenerate or undesirable and who are treated in a negative way. Prejudice is an attitude whiles discrimination is overt behavior and the two usually go together.
A stigmatized person is one who possesses an undesired difference from members of mainstream society which leads society to discredit them. In ancient times persons with leprosy, paralysis or some disability may suffer stigmatization in many forms. Some societies in those days officially opposes racism, sexism, ageism, ableism and other types of prejudices and the unequal treatment of certain individuals. Outlawing discrimination, however, is seldom very successful in changing human behavior. Stigma, which is deep-seated can only be modified over a period of several generations even when laws and policies demand such change.
HIV/AIDS throughout history has become a disease of already stigmatized group. In the initial era of the epidemic in most countries, HIV infection is believe to spread through sexual network of gay men, commercial sex workers, and injecting drug users. These marginalized groups were already heavily stigmatized by society and this prejudice were carried over and strengthened, when such individuals become identified as carriers of HIV. This double stigma of AIDS stemmed from the identification of AIDS as a serious illness and from the identification of AIDS with already stigmatized group. The deplorable nature of the disease was not something many families would embrace but to segregate the individual infected from the ordinary people in order to avoid others from been infected. In India in the 1980’s it was reported that AIDS patients were considered outcast from families and some were given places like separate huts to sleep in and were prevented from coming into contact with anyone. Such was the trend at which persons living with HIV/AIDS suffered.
Homosexual intercourse has often been blamed for starting the epidemic but one must also take a cursory look at sexual intercourse as a whole rather than blaming homosexual sex as a major mode of transmission. The reason to this supposed impression was basically, the fact that homosexual intercourse was not generally accepted in many societies and that many countries were trying as much as possible to halt the gay men relationships or men having sex with their fellow men.
HIV transmission in Ghana has not been different from that with other countries and the infection is known as primary through heterosexual intercourse and not the other way round and stigma to HIV/AIDS occurs as a result of family systems, ignorance, cultural values and so on.
Ghanaians view HIV/AIDS as consequences of sexual immorality or immoral behavior, thus infected individuals are considered responsible for acquiring the disease. In some cases, the infection is perceived as a punishment given by God to perpetuators of sin like prostitution, promiscuity, drugs use or homosexuality. Ghanaians are very religious and moral people and have a value system to which they adhere. It is believed that individuals should abstain from sex until marriage and that those who acquire HIV/AIDS through commercial work or promiscuity bring disgrace to their families and that any member of the family who engages in these debaucheries do so to the detriment of the family.
Therefore, stigma related to sexual immorality is primarily due to cultural values against prostitution or amorous lifestyles coupled with fear of HIV/AIDS itself, due to misconceptions and fatalities associated with the disease. Although there are homosexual sexes in Ghana, the only form of sexual transmission of HIV that working document regard is heterosexual intercourse. The criminal code of 1960(ACT 29) of Ghana makes sexual intercourse an unnatural manner. Persons suspected of homosexuality are swiftly punished and incarcerated by law officials. Homosexual men are harassed, called evil, evicted from their homes and even beaten by members from their homes and community.
The Family system in Ghana also enhances the breeding of stigmatization to HIV/AIDS to some extent. Family members are considered actively responsible for the behaviors of each household members and the family blames or praises for behaviors of it members. An individual is linked to a long chain of the living and deceased members in his family in his or her home town or village. A family member who dies or lives with HIV/AIDS are stigmatized because of the mindset of the community as a whole. They may encourage relatives with HIV/AIDS to remain silent about their status to prevent gossip, social rejection and HIV related stigma. In some cases family members isolate relatives with HIV to minimize social contact.
Again, stigma attached to HIV /AIDS is based on ignorance on the emergence of the epidemic with it modes of transmission. Whiles westerners say the first case of HIV/AIDS was found in some parts of Africa, Africans have also counteracted this view that the proliferation of westerners into our continent have heighted the cases of HIV. However true this thinking may be, one will find out that ignorance has been a major player to this effect. It is of common fear that by associating with people living with HIV/AIDS will put many at risk of being infected with the disease. Such fears have not been different from that of westerners even among people who know and understand the actual means of transmission maybe based on an irrational reaction. The Lethal nature of HIV/AIDS undoubtedly raises the level of fear with most people being looked down upon and some having to loose their jobs at workplaces. Stigmatization to this disease has travelled a long way to the extent that affected persons do not share anything in common with ordinary people. i.e., ordinary people do not eat with them, drink from the same cups, share the same lotion or even come closer to someone suspected to have HIV/AIDS simply for the fact that one may contract the disease by mere touches. These mentalities of many have even subdued the structures put to tackle this social unrest.
Conversely, the effect of stigma to HIV/AIDS has lead to refusal of voluntary counseling and testing for HIV, increased gender based violence and marginalization of high risk individuals. People do not seek VCT because of the fear of discovering that they are HIV positive and fear of the resulting stigma and discrimination that may accompany them HIV/AIDS positive status.
Moreover, Persons living with HIV/AIDS hide their HIV sero-positive status to reduce HIV/AIDS related stigma and discrimination and to retain the care and support of family members. Ironically, this secrecy hinders uptake of treatment and of the support services that can be provided by family members. People who feel stigmatized or discriminated against have poor health outcomes, socio-psychological problems and suicidal thoughts. Tackling HIV stigma will involve tackling perceptions and values towards sexuality and HIV/AIDS.
Lastly, work place discrimination in Ghana has led to low productivity to some extent. After realizing in the workplace that one has HIV, it is believe that the individual is not fit to performing his or her duties. Persons Living with HIV/AIDS (PLWHIV’s) then suffer from idleness or fear of infecting others with the disease and later lead to their dismissals. Another case is the mindset of persons living with HIV/AIIDS. After knowing their HIV infection, most of them feel reluctant and depressed to work due to the mind set about the disease. Persons living with HIV rather use stigma and discrimination as a fiasco for not working and want to look pitiable for people to come to their aid in terms of financial wise. However, there are some who have HIV and are still healthy and working and their conditions have never weighed them down i.e. not reached a deplorable stage (AIDS). All these happen as a result of early and late diagnosis. When diagnosed early, adequate measures are put in place to prevent one from getting to the dying stage, devoid of stigmatization
Despite the enormous efforts by the government to measure the degree of stigma to HIV/AIDS and to avoiding it in the country, more interventions are needed and must continue. For instance is on education to overcoming HIV/AIDS stigma in the country. This is very crucial and education can help break the silence about the epidemic and move it to person, private and public domain. Through interpersonal discussions on HIV/AIDS, individuals and communities can be moved along the continuum from a higher degree stigma towards a lessened stigma. However, approach to HIV /AIDS can move the issue of taboo by making it less taboo and this will silence it. More education about HIV/AIDS stigma should therefore be incorporated in the primary, secondary and university level and even the home level.
Again, humanization HIV /AIDS through disclosure can also help address the issue of stigmatization to HIV/AIDS. As more and more people disclose their HIV positive sautés, the taboo surrounding the infection lessens. This courageous fight helps set the media agenda for the issue of AIDS. They show that individuals living with HIV/AIDS are people just like everyone else and must not be stigmatized or discriminated against in any way. They are children, women, men, gay, straight, wealth and poor, famous persons and ordinary people. In their public appearances, these are “poster people” for the epidemic and stress that they want to be treated well. They want to per sue education, earn a living, marry and become helpers to other and that being HIV positive should not be hindrances to their progress.
Furthermore, organizing people living with HIV/AIDS into support and action groups when networked into a nation wide association , influence national policies and would effect campaigns to decrease stigma and to lobby for free antiretroviral and lobby for benefits such as stigmatization for the diseases.
Finally, government should also establish and implement policies to overcome stigmatization. This policy will allow persons living with HIV/AIDs to enjoy their work without any fear of any dismissal. Such actions will fine any employee who dismisses or ill-treat any HIV/AIDS patient in the workplaces and such enjoyable immunity would help reduce HIV/AIDS stigmatization.
HIV/AIDS is a disease of ignorance and intolerance as well as a biological; illness and not a punishment from God. It can affect the blind, the cripple, the insane, rich, poor, black, white, homosexual, heterosexual, pastor and even the congregation. If hypertension kills but it is not stigmatized, why should HIV/AIDS a disease which can be managed and controlled like hypertension be stigmatized. HIV does not kill but stigma and discrimination kills
Written By: G.B Adu-Takyi
