Many people living with HIV in Mozambique's Manica Province, near the Zimbabwe border, suffer more as a result of stigma than from a lack of medication, hunger or poverty.
"I lost my home. My family isolated me and even went so far as to separate the utensils I used; they were afraid of becoming contaminated," said Nussanema Samuel, 28. She has had to build a new life since she revealed her HIV-positive status to her family and friends in Machaze, in the south of the province, three years ago.
"My friends abandoned me and I would go for as long as two days without bathing because there was no one who would help me. I became sick because of discrimination," she told IRIN/PlusNews.
A 2005 survey by Shinguirirai ("courage" in the Shona language), an association for people living with HIV/AIDS, showed there were many forms of discrimination against HIV-positive individuals.
In the neighbourhood, they suffered insults; in the family, abandonment and isolation; at work, rejection and job loss; and at church, condemnation. Even at health centres they reported lengthy waits for assistance and more insults.
"The prejudice is worse when it's a woman," said Samuel. "When a woman reveals that she is HIV positive, society vehemently condemns her, but when men publicly reveal they are HIV positive, society accepts it more easily."
The nation's 2005-2009 Strategic Plan to Combat AIDS approved the principle of promoting and protecting the human rights of people living with HIV, but until those principles were translated into legislation they would have limited impact, Samuel said. The first law protecting people living with HIV was passed in 2002, but only covered discrimination in the workplace.
The Mozambican Network of Organizations Fighting Against HIV/AIDS (known by the Portuguese acronym MONASO) submitted a proposal for more comprehensive legislation in 2005, but a draft version of a bill has yet to be reviewed and debated by parliament.
Accord against prejudice
In 2007 a group of HIV-positive people in Machaze founded Tchitenderano ("accord" in the Ndau language) to campaign against stigma and discrimination in their district, where HIV prevalence is 16.7 percent, slightly higher than the national average of 16 percent. So far the group has helped more than 3,000 people.
|The prejudice is worse when it's a woman|
Tchitenderano has 25 activists who hold lectures at various public institutions to educate people about HIV and other sexual and reproductive health issues. They also visit health facilities to encourage patients to adhere to their antiretroviral (ARV) treatment, and provide home-based care.
Samuel Doris Campira, president of Tchitenderano, said the organization was slowly helping to free Machaze district of discrimination and stigma. "There were people who would spit at us when they walked by where we were meeting, but today there are families with HIV-positive individuals at home who seek us out to become better informed," he said.
Eusébio Sixpenze, a government spokesperson for Machaze district, noted that "Nowadays we have public employees who are open about their HIV-positive status, not because their jobs are guaranteed by law, but because they know they will have the support of their workmates."
Campira said, "The stigma is still very strong, despite the legislation and the campaigns," but with time, information and patience, he believed communities would eventually change their attitudes.
"I wasn't ready when I made the decision to leave my parents' house, but I gathered all my strength and faced the struggle," said Samuel. "I'm not sorry I was open about by HIV status. In fact, I think it was the right time to liberate more people who were in the same situation as I was. Now we have an association and formal support that provides us with encouragement."