Dr. Avnish Jolly:A diagnosis of HIV infection is always profoundly shocking. Feeling of fear, anger and despair and thoughts of suicide, are common in the hours and weeks that follow.
*Where do people turn for comfort and guidance at such times?
*And who is most likely to care for them when they become too sick to look after themselves?
It is important for everyone in the community to share the challenge for caring for the people who are infected with HIV/AIDS. While we may hope that doctors, nurses and hospitals will take care of PLWHA, it is actually far better to look after and comfort them in their own homes and communities. Everyone in their community needs to do their role in this effort. Some may care and provide for PLWHA, other may provide kindness and compassion for the families and friends of PLWHA. All these functions are part of what we call "CARE".
Stigma is one of the major challenges that PLWHA face. Stigma, silence, discrimination and denial undermine prevention and care strategies and increase the impact of the epidemic on an individual. Stigma is most deeply felt when one has just received an HIV positive diagnosis. This
could be due to the emotional struggle within oneself i.e. fear, shock, anger, depression, frustration, denial bargaining and asking oneself "How will society look at me?" There are many reasons – internal, external and spiritual – why people feel stigmatised.
SELF-STIGMA is internal. It begins with an individual not seeing the benefit of living and looking at themselves as unfortunate and contemplating what other people are going to think about them.
"You are always conscious about your physical appearance and mental status and always checking for signs that will alert others that you have HIV."
Self-stigma is partly caused by fear of how other people will relate to you – fearing denial, exclusion, loss of property, employment, educational opportunities, eviction, and abandonment by friends. The environment at a given time determines the level of stigma: where there is a high level of awareness there is less stigma. An HIV-positive, if determined, can be supported to overcome self-stigma. Disclosure is the best tool to deal with stigma:
"Start by understanding how to control your emotions, understanding people’s feelings, then break the silence. When you do it yourself people will not talk about you behind your back."
*Who is the infected person?
*Why do we have to waste time waiting for people to go through the process opening up when we are all affected based on the fact that we have lost so many of own close family members?
SOCIAL STIGMA refers to social attitudes and norms that stigmatise PLWHA. The individual often feels forced to do a ‘self withdrawal’ for fear of being judged, ostracized or shunned.
An example is the social attitude that ‘AIDS is for prostitutes, for people who have nothing to offer.’ In order to support PLWHA to cope and live positively, it is important to understand and address these issues both at personal and social level. Stigma in some countries where insurance policies exist. People fear to open up as they risk losing the insurance benefits.