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The twin evils in the fight against HIV/AIDS

Pretty in red: Talya, founder of LeFlea Boutique

"In my view, it is this misinformation and lack of accepting attitude towards PLHIVs and the resulting discrimination and stigmatization which are our biggest obstacles in the fight against HIV/AIDS transmission." - Talya Stones.

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As a volunteer with Action for AIDS Singapore (AfA), it was interesting to both see and be a part of this year's campaign for World AIDS Day on 1 December as it unfolded. The campaign – Let's Be Positive about People Living with HIV – sought to take a positive stand against social stigma and discrimination against people living with HIV/AIDS (PLHIV) in Singapore and increase acceptance towards.

It was a bold move by AfA which for the first time bravely stepped out with a TV campaign with the support of local celebrities Xiang Yun, Adrian Pang, and community opinion leaders A.B Shaik and Royston Tan. The campaign sought to educate the public on how isolated PLHIVs can feel as a result of the stigma and discrimination they can face because of their status. For many, this manifests in the loss of simple things that most would take for granted – like sharing a dinner with friends or family.

And this is because despite an improvement in knowledge of HIV prevention, the accepting attitude towards PLHIVs is still low. While only 66.5% of respondents of the latest Omnibus survey on the subject are willing to care for a close relative with HIV/AIDS, an even lower and disappointing 40.7% are willing to share a meal with a person with HIV/AIDS.

In my view, it is this misinformation and lack of accepting attitude towards PLHIVs and the resulting discrimination and stigmatization which are our biggest obstacles in the fight against HIV/AIDS transmission.

If people are fearful of being rejected by their friends, families and society, and of losing their jobs and income, then this very much stands in the way of people being willing to go for voluntary anonymous testing. Pair this with a fear of not being able to access support and treatment because they believe treatment is unaffordable, because they do not know help is at hand, and we have a double deterrent.

And as long as people are not going for voluntary testing, so long as they don’t know their status, they are unable to take preventative measures to stop the spread to loved ones or those who they are having sexual relations with.

And the longer the virus goes undetected - of the 200 Singapore residents detected to be HIV-infected in the first six months of 2011, 58% of them already had late-stage HIV infection when they were diagnosed - the more damage the virus will do to the immune system and the harder it is to treat. If we let discrimination and stigmatization prevail, this is the route we are choosing for Singapore - the silent time bomb which ticks along everyday.

While progress is being made to stamp out discrimination and stigmatization in relation to PLHIVs, there is much more work to do, and the roadmap looks something like this:

• People need to understand that HIV is no longer a death sentence. On the contrary, it is now a manageable chronic disease. They also need to understand that early diagnosis and effective medication can suppress HIV and the delay and progress of the infection.
• There needs to be improvement in education surrounding the issues mentioned above and a concerted effort made to correct erroneous and harmful misperceptions. More visibility and open discussion of causes and appropriate responses need to be underway. Teachers, the media and of course the public have a leading part to play here. We need to deal with this together in a single-minded fashion.
• People need to be assured that confidentiality and privacy is not compromised. The public needs to be reassured that their HIV status is kept confidential. Companies need to set examples by taking a forward-thinking approach to arrive at fair and informed employment policies with regards to HIV.
• Employees need to be reassured that their financial stability will not be affected by their HIV status – areas in need of particular attention are discrimination laws, corporate acceptance to recruit PLHIVs and insurance policies.
• More clear information needs to be provided regarding the availability of reasonably affordable medication in Singapore. There needs to be better reassurance for those who cannot afford medication that help is at hand, thanks to the assistance of several welfare organisations, including AfA.

While the number of people reported to have HIV/AIDS in Singapore might be comparatively small at 5,045 (since 1985), our position as a travel and business hub along with high numbers of infections in surrounding countries, make it possible that we could be in a position to experience a more serious epidemic in the future.

If we continue to let stigmatization and discrimination manifest, if we see PLHIVs as a problem rather then the solution in the fight against HIV/AIDS, if we let a lack of understanding, prejudice and fear take root and multiply, we will be fanning the flames of transmission with ignorance.

So let us all do our part in whatever ways we can to fight transmission by taking every opportunity to be open and educate those around us about these issues, and unite in our effort to stamp out stigmatization and discrimination.

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By Talya Stone

Talya Stone is a blogger at Ms Demeanour Singapore and volunteers with Action for AIDS (AfA), Singapore's leading non-governmental, voluntary, community-based organization committed to AIDS prevention, advocacy and support.