ICN Press Release 2003 [Stigma, Discrimination and the Conspiracy of Silence Are Fuelling the AIDS Epidemic]

Stigma, Discrimination and the Conspiracy of Silence
Are Fuelling the AIDS Epidemic

ICN calls on governments, religious institutions and civil society leaders everywhere to replace silence, fear and blame with solidarity and hope

GENEVA, 12 May 2003 - Stigma and discrimination fuel the HIV/AIDS epidemic by creating a culture of secrecy, silence, ignorance, blame, shame and victimisation, says the International Council of Nurses (ICN). “Stigma prevents societies from addressing HIV/AIDS with the appropriate health care services, legal and educational strategies,” declared ICN president Christine Hancock. “What stops them is HIV prejudice. And all that will stop HIV prejudice is speaking openly about the facts. It is past time for governments, civil society leaders and religious institutions to end the conspiracy of silence and shame surrounding HIV/AIDS.

”Stigma and discrimination are major barriers to utilising health services for prevention, diagnosis and treatment ¹ . The shame associated with HIV/AIDS discourages individuals from seeking voluntary counselling, testing and treatment and blocks prevention efforts.

It also impairs their ability to access care, to manage appropriate self-care or to participate in research studies aimed at finding solutions. Many people prefer not to know their HIV status for fear of loss of confidentiality and the associated risk of stigma, loss of job, break-up of relationships, social ostracism or even violence. It also means people may not take preventive measures to protect themselves and their partners from HIV infection. Fear of becoming stigmatised prevents people vulnerable to HIV infection from accessing testing and treatment services.

Stigma directly affects the capacity of governments to respond effectively to the devastation of the HIV/AIDS epidemic. The fears and taboos surrounding the disease translate into silence and inaction, despite the catastrophic consequences for individuals and societies. Opportunities for prevention are missed, care and treatment remain inaccessible and the toll of death and misery climbs.

Though health care providers worldwide show great compassion and courage daily in caring for people living with HIV/AIDS, unfortunately they too can be perpetrators of stigma and discrimination. A non-supportive and stressful work environment causes staff burnout and exhaustion. If health workers see that infected colleagues are stigmatised, not cared for or even terminated from employment, they will tend not to care for others, especially if it involves a risk of exposure. A caring and supportive environment attentive to universal precautions will help reduce stigma and discrimination.

Religious organisations have done very little to challenge negative attitudes toward those living with the disease. The international symposium Religious Health Organizations Break the Silence on HIV/AIDS, was organised during the 13th International AIDS Conference in July 2000. There it was noted that religious doctrines, moral and ethical positions regarding sexual behaviour, sexism and homophobia, and denial of the realities of HIV/AIDS have helped create the perception that those infected have sinned and deserve their ‘punishment’.

The battle against stigma has many fronts, but begins with acknowledging the terrible power and pervasiveness of HIV/AIDS stigma and prejudice.

Efforts must be put into education to encourage better understanding of AIDS and the HIV virus. Understanding and support for people living with HIV/AIDS must be promoted and their contribution to policy and programmes be encouraged. Supportive policies and legal constraints must be fought for. Discrimination against people living with HIV/AIDS is a violation of their human rights. A framework based on human rights provides a means of monitoring and enforcing their rights, as well as addressing discriminatory practices.

HIV/AIDS-related stigma and discrimination challenge everyone. Interventions to address stigma will only work if effective partnerships are built between governments, health care professionals and civil society, and with the active involvement of people infected and affected with HIV/AIDS.