Dr. Avnish Jolly:"The moment you mention you have HIV – you miss the benefits."
Experience has shown in cases where political/ democratic environment is not conducive stigma is escalated among even those who would have accepted to come out in the open. On the other hand when the HOLISTIC environment is conducive the level of stigma gradually reduces. Hence enabling not only PLWHA to cope but the entire society and come to terms with the infection.
ROLE PLAYED BY PLWHA IN STIGMA REDUCTION should be underscored. However we must be reminded that we really need to show HIV/AIDS wearing a "professional and skilled face".
This effort is being hindered by the fact that there are no policies to safeguard discrimination of PLWHA in employment. However, a successful example was cited of "Giving HIV a professional face," Of the alliance of HIV-positive professionals in Nigeria.
FAMILY STIGMA: Family members making them understand and appreciate the dilemma you are in, as many of them may relate your situation to your past behaviour. Some of them may relate past deviation from expected behaviour in society to your current predicament. The situation is worse when it comes to your immediate and close family members like your children whose understanding, depending on age, is limited to the obvious facts of life. These difficulties heighten the fear of opening up to one’s family and impede the individual’s ability to cope with HIV.
AIDS and other issues in the family, enabled parents to cope with difficulties of disclosure at family level and to reveal HIV status to children, and to increase support and co-operation from children.
Following are some Issues which are very important for caring of PLWHA:
– What is the role of disclosure in fighting stigma?
– What are the effects of HIV-related stigma on individual, family, community, and children?
– What are the predisposing factors to self-stigma and are they uniform or do they vary from community to community?
The following chart represents various caring agencies for the PLWHA
in the community.
A) Informal Agencies
a) Home Based Care
b) Self Help Groups
c) Religious Groups
B) Formal Agencies
a) Health Sector
b) Hospice Care
c) Government and NGOs Support
A) Informal Agencies
a) Home Based Care: – PLWHA requires long and continues treatment. Hospital care in such condition is not feasible. So home-based care is absolutely necessary for care of such cases. The home-based care has some specific objectives.
1) Formation of indispensable terms that will train the family members who will provide social support and teach prevention. They will develop referral networking linking health services with NGOs.
2) Clinical Management: A proper diagnosis and treatment.
• Follow Up
• Nursing Care
• Medical Care
• Infection Control Practices
• Counselling has to be done on HIV testing to reduce stress and anxiety and plan for the future. The home care will include training of the family members; provide moral support and also linkage to social welfare.