A recent survey done among persons living with HIV/AIDS found that more persons are accessing anti-retroviral (ARV) medication and receiving care and support but they still complain about experiencing discriminatory treatment in the health sector although stigma is said to be the bigger problem.
The survey, done among some 300 HIV positive persons including some from the Georgetown and Mazaruni prisons, also found that medical personnel were cited as the major source of the unfair treatment being experienced and social workers and caregivers to a lesser extent.
Another key finding of the survey was that stigma is more a problem than discrimination.
However, the survey pointed out that since medical institutions are the source of treatment and medication for the great majority of infected persons, it is not surprising that they figure prominently in a question of this nature.
Context
Meanwhile, well-known HIV/AIDS activist and founder and chairman of Lifeline Counselling Services, Dereck Springer said that the issue of discrimination at medical institutions should be taken in context. He noted that persons should take into consideration the conditions under which medical employees work which sometimes would leave them stressed and in dealing with the public this may be evident in their attitudes. He said that the HIV positive persons may then feel that the only reason the workers are acting in such a manner is because they are infected.
Springer pointed out that Guyana has come a far way from the days when the virus was known as the “gay plague” and when working at the Genito-Urinary Medicine (GUM) clinic meant that a person had to be HIV positive.
But he cautioned about being complacent while adding that a lot of money is now being spent in the area to the extent that it has become “sexy” to work in the area but noted that the money has been used in the “spending down of the epidemic.”
The change in society could also be attributed to the fact that almost everyone knows someone who is infected.
Titled ‘Survey of Stigma and Discrimination Experiences of HIV+ Guyanese’, the survey was conducted through the National AIDS Committee (NAC) who used HIV-infected persons to conduct the interviews. The 300 correspondents came from nine regions and according to NAC it was done mainly to assess the impact of stigma and discrimination on infected persons.
The findings of the survey were revealed at a forum yesterday which saw representatives from various organisations working in the area.
The NAC, which says it is not an executing body, hopes that entities could use the result to take action in the area. The participants comprised 60% females and 40% males with some 64% coming from Region Four and 57% being Afro-Guyanese. Forty-nine percent of them had been infected between one to five years and 70% were below the age of 40.
On a positive note it was found that 78% of those interviewed were receiving HIV drug treatment. And while 57% felt access to treatment had improved another 26% reported that the situation had worsened.
Twenty-five percent reported negative experiences and more than half of that number cited incidents in medical institutions with a smaller amount citing their workplaces.
Meanwhile, the survey found that two-thirds of the respondents were in need of and received care and support while some 78% acknowledged “never experiencing unfair treatment.” “Of those reporting unfair treatment (22%), almost two-thirds had occurred in government institutions, with 22% and 18% respectively identified as private sector and NGO.”
Disclosing status
According to the survey 85% of the respondents disclosed their status while 34% of them had experienced some form of unfair treatment as a result. The source of the unfair treatment incidents was family members while 17% said it happened at their workplace, 10% was housing and religion was the source of nine percent of the unfair treatment.
Another positive coming out of the survey found that 52% of those interviewed were employed while the rest were not. Fifty percent found that access to employment for infected persons over the years had not changed and 17% and 14% felt it had improved respectively or deteriorated.
Interestingly, 14% of those refused jobs because of their status said they were told this by the employer, while 12% stated that they were dismissed from their jobs because of their status.
Further, the survey found that a significant number of respondents suffered loss of income because of their status with most of them reporting that it happened because of poor health.
Again it was found that most of those who suffered stigma did so at the hands of their relatives with “judgemental attitudes being signalled out as the most prevalent type of stigmatising behaviour.”
Stigma the bigger problem
According to the survey fears generated by attitudes that stigmatise infected persons, particularly in family and religious circles, are of greater concern than overt acts of discrimination. “Judgemental attitudes, generating shame and embarrassment, add up to powerful influences to deter people in Guyana from disclosing their HIV identity. In turn, failure to disclose generates many negative personal, societal, medical and economic consequences,” the survey said.
It pointed out that if persons do not disclose their status to their family then it is unlikely that they would do so at all although females are still likely to access treatment but some distance away from where they live. However, men would respond to the fear of being stigmatised by resisting treatment until they are about to die.
And while stigma is said to be systematic, the survey found that acts of discrimination appear to be more isolated.
