10 times more people tested for HIV in the Thandizani areas than elsewhere and the HIV rate was 50 per cent lower.
Stigma and the stigmatised
But it's not always so simple in Africa - or other parts of the world.
In the Caribbean, for instance, the violent stigma surrounding homosexuality
reminds us that stigma remains the biggest single obstacle to progress.
It distorts both our knowledge of the epidemic and attempts to contain
it.
Questions were raised at a meeting of Caribbean nations about the true
breakdown of HIV infections in this community. Janice Dale, a journalist
from the Jamaican Weekly Gleaner, disputed the reported proportion (only
eight per cent) of HIV cases due to Jamaican men having sex with men.
"You don't know how many there are because they continue to live
in denial," she said. "Positive people continue to be in fear
of their lives and jobs."
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In other parts of the world, it is women who
Paul Farmer, treatment provider
bear the most stigma. Dr Suniti Solomon talked about the
discrimination against women in India and China. If a woman was found
to have HIV, it was assumed she was a prostitute, but if a man became
positive he was just seen to have got unlucky in his sexual exploits.
Kevin Osborne of South African health lobbyists the Policy Project said:
"I've lost count of the number of times this week medics have mentioned
stigma as the driving force behind Aids." But researchers have not
even got round to measuring such a slippery subject. How do you know if
stigma has 'got better'? How does internalised stigma - self-oppression
- reinforce social stigma? Exactly how does it stop people accessing services?
Until questions like these were answered, fine words are no
Chilando Mukuka-Chilarka, prevention expert
use.
