The widespread fear of stigma and discrimination still leaves many HIV-positive people in Swaziland feeling so despondent they put their lives on hold. Many HIV-positive women have decided not to have children, while some feel marriage is no longer an option, a new survey has found.
“It all has to do with stigma. No matter how much education we try to give the people, the old attitudes against people living with HIV and AIDS persist. This is why when people find out that they are HIV-positive some of them quit their jobs and school and just give up on tomorrow. Society has told them they are finished, and they have been conditioned to believe this,” said Angelica Masuku, an AIDS activist with one of the HIV support groups grouped under the Swaziland National Network of People with HIV and AIDS (SWANNEPHA).
The network commissioned a study of HIV-positive people that looked at their feelings and attitudes towards their status and compiled the results in an inaugural Stigma Index Report. The survey interviewed more than 1,200 participants and found that 45 percent of HIV-positive women surveyed said that having learned their HIV status they would either have no children or no more children. About 18 percent of the participants said they would not get married, while 22.5 percent said they were abstaining from sex.
“Why women with HIV don’t wish to have children is they fear that when they go to the clinic, people will be harsh on them for having unprotected sex [when] they are known to be HIV-positive,” SWANEPPHA Director Thembi Nkambule told IRIN/PlusNews.
In addition, HIV-positive women were still concerned about the risk of transmitting HIV to their unborn babies, despite the country's relatively successful campaign to prevent mother-to-child transmission, Nkambule said.
Swaziland is on track to meet its national target of providing antiretroviral (ARV) prophylaxis to 90 percent of pregnant women living with HIV by 2014. In 2009, 88 percent of HIV-positive pregnant women and 82 percent of HIV-exposed infants were given prophylactic ARVs, according to the UN Children’s Fund (UNICEF).
Withdrawing from life
But the stigma index suggests the despair that accompanies knowledge of a positive HIV status has not significantly affected employment: only 5.5 percent of HIV-positive people surveyed said they had stopped working, while 5 percent reported that they decided not to apply for a job or a promotion.
According to the survey, lack of family and social support is the most pressing problem for HIV-positive Swazis, who comprise 26 percent of the adult population in this small country of about one million people.
About 35 percent of respondents said they lived in fear of discovery and more than a quarter said others were afraid of contracting HIV from them through basic physical contact or close proximity.
|All of this is bad news for those of us who are pushing hard against stigma. We know the way to combat AIDS is for all the people of Swaziland to admit that it is very common and not something alien ... but we are failing ... This just spreads HIV on and on|
The fear of physical violence from family, friends or strangers who learned of their HIV status remained a major barrier in efforts to encourage people to disclose, the study found.
“Such statistics indicate that we have a long way to go. We need to inform the public that because [you have] HIV [this] does not mean [you] will die the next day. With the proper usage of interventions people can raise families, but all that is needed is knowledge,” said Nkambule.
For Sizwe Simelane, an HIV testing and counselling officer in the capital, Mbabane, the most disturbing finding is that 13 percent of respondents said they considered having HIV/AIDS “shameful”. Women are more inclined to blame themselves. For every man who expressed shame at being HIV positive in the survey, three women did so.
“All of this is bad news for those of us who are pushing hard against the stigma. We know the way to combat AIDS is for all the people of Swaziland to admit that it is very common and not something alien. It is a medical condition, not a moral judgment. But we are failing, and people are not getting tested because they fear the results. They don’t want family and society to know so they refuse to know themselves. This just spreads HIV on and on,” said Simelane.
The government estimates that only 16 percent of people have been tested for the virus. About 65,000 HIV-positive Swazis are on ARV treatment, out of an estimated 200,000 HIV-positive people in the country.