Why Afghanistan Must Confront HIV-Related Stigma – MENAFN.COM

(MENAFN – Khaama Press)

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Throughout the course of human history, there have been few health conditions more mired in socializing stigma than HIV/AIDS. Despite transformative advances in medicine that have given renewed hope to millions of HIV/AIDS patients around the world, deep-seated public perceptions and stigma associated with the condition have been slower to evolve. As it were, Afghanistan is no stranger to the adverse effects of public stigma surrounding HIV/AIDS. So long as comprehensive, education-based approaches for stigma reduction are not systematically implemented nationwide, present efforts to combat the spread of the virus will see diminished effectiveness and sustainability.

Globally,
much of the contemporary HIV-related stigma is rooted in the misinformation
perpetuated across the decades since the origins of the epidemic. Initially,
public hysteria in the face of sparse and unverified information about the
spread of the virus bred discrimination-laden public practices and policies.
While these practices largely masqueraded as precautionary attempts to curtail
infection rates, their continuing legacy has been an ingrained set of biases
and stigmatizing attitudes regarding HIV, HIV modes of transmission, and HIV
patients. The tangible impact of this stigmatization was most aptly summarized
by a patient living with HIV whom I once spoke with, who poignantly noted,
‘When you tell people that you have HIV, they feel like they can automatically
assume something about you and your history.’ 

The
harm of HIV-related stigma extends beyond interpersonal injury. When
individuals are shamed out of initiating conversations with healthcare
providers or shamed into withholding critical behavioral and health information
from healthcare providers, they are likely to miss out on learning about
options for HIV/STD testing. Without knowing their HIV status, afflicted individuals
will lose valuable time to pursue a treatment course, the ultimate effects of
which put a strain on the entire health system. Even the Joint United Nations
Programme on HIV and AIDS highlighted this problem when the body issued a
report describing stigma reduction as an indispensable component of the global
fight against AIDS (‘Confronting discrimination: overcoming HIV-related stigma
and discrimination in health-care settings and beyond,’ 2017).

Another
key effect of HIV-related stigma is its implications for hindering accurate
data collection on HIV infection rates. In Afghanistan, the size of the
population of HIV-positive patients has been debated, with notable differences
in the incidence rates provided by Afghanistan’s Ministry of Public Health and
the World Health Organization. What is clearer is that the figures probably
represent an underreporting of the issue, since afflicted individuals may be
less likely to actively seek out treatment for fear of being subject to
harassment and discrimination based on their status. This deleterious silencing
effect is pronounced for the most vulnerable populations, including women and
children, for whom rates of infection have risen in tandem with spikes in drug
usage and needle sharing.  

Given
the manifest and system-wide harms of HIV-related stigma, particularly in the
Afghan context, it is clear that stigma reduction interventions must take hold
in a timely fashion. History has shown repeatedly that attitudinal changes are
not a natural outcome of passing time but instead require deliberate,
programmatic action. An education-based approach that challenges widely
ingrained, myth-based biases and includes up-to-date information about
prevention and testing options would seem to be an effective first step. Coordination
among the Ministry of Public Health and the Ministry of Education to integrate
this type of educational intervention into school curricula could have a
promising impact in terms of increasing individuals’ self-efficacy in managing their
own health. 

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