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It's better to light a candle than to curse the darkness

     

Stigmatization & Discrimination

http://www.jharkhandmedicaljournal.com/

Most ,if not at all , basic human rights and freedom ,laid down as the common standard of  achievement for humanity more than 40 years ago have been challenged ,violated , or denied in the context of HIV/AIDS.  The AIDS has become synonymous with stigma ,ostracism ,repression and discrimination,as individuals affected by HIV have been rejected by their families, their loved ones and their communities. This rejection holds as true in the rich countries of the north as it does in the poorer and developing countries of the south.  The epidemic of fear ,stigmatization and discrimination has undermined the ability of individual families and societies to protect themselves and provide support and reassurance to those infected . Persons with HIV/AIDS face double jeopardy; they face death ,and while they are fighting for their lives they are often denied access to all areas of life -from health care to housing ,from education to work to travel. Where as most illnesses produce sympathy and support from family ,friends ,neighbors ,persons with AIDS are frequently feared and shunned. Thus AIDS discrimination cutting across lines of race ,gender ,ethnicity and sexual orientation is a serious problem. It also causes considerable economic cost to the community ,producing both individual distress and social disruption.  HIV/AIDS -related discrimination is becoming more extensive ,more sophisticated and more strongly entrenched worldwide. It hinders the community 's efforts to effectively and efficiently minimize the transmission of HIV. Safeguarding the human rights of persons with AIDS is vital not only on ethical and legal grounds but for pragmatic reasons. It is a necessity ,not a luxury.

     

To minimize discrimination a carefully planned and appropriately resourced strategy is necessary .A variety of measures ranging from making changes in the area of human rights legislation and enforcement have been recommended. Although recommendations for future anti-discrimination efforts by American Civil Liberties(1990) include - strengthen anti-discrimination law ,upgrade enforcement of anti-discrimination laws ,expand legal services ,increase over-right of insurance practices ,target education about the law for health care providers . We must remember that for people living with HIV/AIDS ,there are often compelling disincentives to seeking redress for discrimination through the courts; going to court takes time and resources -diminishing commodities for most people with HIV/AIDS. Going to court may entail publicity and the accompanying risk of further exposure to discrimination.  The failure of governments to protect people living with HIV/AIDS from discrimination through the active enforcement of such legislation is a violation of their human right. The apathy of some governments in providing effective systems of prevention ,treatment and care may arise from more deep-seated stigmatization at a societal level.

     

Different forms of discrimination 

HIV/AIDS related stigmatization and discrimination can appear in a variety of levels and in variety of contexts. Mapping those forms is the first step towards being able to identify their determinants. Pre -existing local cultural practices and beliefs are both determinants and legitimators of HIV/AIDS -related stigmatization, discrimination and denial. Socio-economic and relative financial security can influence stigmatization process .There is a strong gender bias in HIV/AIDS related stigmatization and discrimination.

 

[ From deliberation of Dr NK Singh at Chennai APICON-02]