DENIAL

Because HIV/AIDS carries so much stigma (qv) there are many pressures for denying a seropositive status or not seeking a test. Individuals may have a psychological aversion to hearing news of what is considered to be virtually a death sentence and there are more practical disadvantages such as the high chances of being sacked or difficulties in getting insurance as well as marital problems when serostatus is known. At governmental level there may be denial of statistics because it is assumed that this will frighten away investment or tourists. The most prominent cases recently have been in South Africa where commentators have talked of an epidemic of denial. Only about 5% of the more than 4 million infected know their status and government ministers refuse to take tests. Some people fear they will be infected by the test itself. On death certificates in the booming funeral industry "natural causes" is usually written in even when the serological status of the deceased is known. President Mbeki has denied that there is a proven relationship between HIV and AIDS saying a virus cannot cause the constellation of diseases in a syndrome and that too little is known about the characteristics and causes of the South African situation. Mbeki has also been opposed to antiretrovirals, even when offered by the pharmaceutical companies, claiming they have toxic side effects. A very good general study is UNAIDS - 2000 - HIV and AIDS-related stigmatization, discrimination and denial - forms, contexts and determinants - Research studies from Uganda and India - Doc 00.16E