MYTHS AND MISCONCEPTION IN HIV,
IMPACT OF HIV,STIGMA AND
DISCRIMINATION
JHM
• A Myth is an imaginary, fictitious or invented story about a thing or
event.
• A Misconception is a wrong understanding of a thing or concept
Some of the common myths includes ;• HIV/AIDS is a black man’s disease that only affects the poor and morally loose
people.
• Goat milks cures HIV/AIDS
• Some AIDS male-patients believe that they can be cured if they have sexual
intercourse with baby girls or virgins; a problem that has led to many sexual
assaults.
• Cultural beliefs that women are the receivers of sex, while men are required to
have as many sexual partners as possible and that condom often undermines
manhood.
• That it is better not to go for HIV test because “what a man does not know
does not kill him”.
• HIV/AIDS is a disease limited to a certain community.
• HIV/AIDS can be cured through blood exchange
Misconceptions
Some of the common misconceptions about HIV/AIDS includes
• It’s possible to get HIV by being around people who are HIV-positive.
• Mosquitoes spread HIV.
• Straight people and non drug abusers can't get HIV.
• One can tell if partner is HIV-positive by just looking.
• No need to worry about getting HIV as there are drugs for its treatment.
• Being HIV-positive is a death sentence.
• Being HIV positive means having to take dozens of pills every day.
• HIV positive people can’t have kids.
• AIDS is genocide.
HIV/AIDS IMPACT
• The impact of HIV/AIDS is cross-sectoral and systemic leading to wider and
deeper poverty for individuals and countries.
• In Africa, HIV/AIDS is linked to many other problems, such as poverty and
poor public infrastructures.
• Over 70% of the world's 40 million people living with HIV/AIDS are in Africa
• What distinguishes HIV/AIDS from other fatal diseases is that:
It primarily affects the most productive age group of men and women
between 15 and 60 years—the main breadwinners and heads of households
raising families and supporting the elderly—and their children;
Its full impact is revealed only gradually (given a median survival period of
around 9 years in developing countries);
There is no cure for HIV/AIDS.
• HIV/AIDS erodes the basics of human development and brings about
destruction of social capital. It interferes with the knowledge base of society
leading to weakening of institutions
• Various sectors that are impacted by HIV/AIDS are:
Production sectors: agriculture, industry which leads to inhibition of private
sector growth
Governance, civil services, armed forces, education, health, judiciary,
household
Household Impact
• Overall impact is devastating – particularly at family and household level
because of the increased burden on the extended family due to loss of
income, increased health care expenditure and reduced agriculture production
• Life expectancy reduced by 20 years from 67 years to 47 years and there is
increase in dependency ratio by an extra 8 members per family earner
• Household income has reduced due to loss of bread winner or morbidity
which makes them unproductive thus there is decreased food production and
lack of basic necessities in the households.
• HIV/AIDS brings a major strain on household resources since there are
expenses incurred such as healthcare expenses and funeral costs.
• Emotionally, household members are affected while taking care of a person
sick with AIDS due to the various demands
Impact on Social Structures
• Due to the HIV/AIDS pandemic, numbers of orphans are large and growing. This
eventually affects the social support systems such as children’s homes which in
the long run become overwhelmed due to the numbers.
• Sometimes the eldearly (grand parents) are the one who takes care of these
orphans
Impact on children
• The pandemic not only causes children to lose their parents or guardians, but
sometimes their childhood as well.
• As parents and family members become ill, children take on more
responsibility to earn an income, produce food, and care for family members.
• It is harder for these children to access adequate nutrition, basic health care,
housing,clothing and education.
Impact on enterprises and workplaces
• HIV and AIDS dramatically affect labour, setting back economic and social
progress.
• The vast majority of people living with HIV in Africa in the prime of their
working lives.
• AIDS damages businesses by squeezing productivity, adding costs, diverting
productive resources, and depleting skills.
• Company costs for health-care, funeral benefits and pension fund
commitments are likely to rise as the number of people taking early
retirement or dying increases.
• Also, as the impact of the epidemic on households grows more severe,
market demand for products and services can fall.
• The epidemic hits productivity through increased absenteeism.
Impact on Health Systems
• In health care, there are high costs of treating HIV and related infections &
cancers, increased bed occupancy by HIV related problems and patients stay
longer in hospitals.
• The HIV pandemic has led to increasing child morbidity/mortality,resurgence
of tuberculosis and other diseases
Impact on Health professionals
• Health workers have to cope with death and dying of patients and may
experience depression associated with witnessing the decline and deaths of
patients due to identification with patients.
• There is work overload and burnout associated with extra time demands of
terminal AIDS care among he patients who have been admitted in the
institutions.
Impact on agriculture
• Absenteeism caused by HIV-related ill-nesses and the loss of labour from AIDSrelated deaths may lead to the reduction of the area of land under cultivation and to
declining yields resulting in reduced food production and food in-security.
• The loss of labour may also lead to declines in crop variety and to changes in
cropping systems.
• The reduction in labour supply through the loss of workers to HIV/AIDS at crucial
periods of planting and harvesting could significantly reduce the size of the harvest,
affecting food production.
• Loss of knowledge about traditional farming methods and loss of assets will occur as
members of rural households are struck by the disease and are not able to pass on
their know-how to subsequent generations.
• HIV/AIDS has caused shifts of production from cash crops to food crops in AIDSaffected households.
• HIV/AIDS has caused a decline in the supply of labour for food and livestock
production.
• The HIV and AIDS epidemic adds to food insecurity in many areas, as agricultural
work is neglected or abandoned due to household illness.
Impact on economy
Labor Supply
• The loss of young adults in their most productive years will affect overall
economic output.
Costs
• The direct costs of AIDS include expenditures for medical care, drugs, and
funeral expenses
• Indirect costs include lost time due to illness, recruitment and training costs to
replace workers, and care of orphans
Mechanisms by which AIDS affects macroeconomic
performance
• AIDS deaths lead directly to a reduction in the number of workers available. As
younger, less experienced workers replace these experienced workers, worker
productivity is reduced.
• A shortage of workers leads to higher wages, which leads to higher domestic
production costs. Higher production costs lead to a loss of international
competitiveness which can cause foreign exchange shortages.
• Lower government revenues and reduced private savings (because of greater
health care expenditures and a loss of worker income) can cause a significant
drop in savings and capital accumulation.
• This leads to slower employment creation in the formal sector, which is
particularly capital intensive.
• Reduced worker productivity and investment leads to fewer jobs in the formal
sector. As a result some workers will be pushed from high paying jobs in the
formal sector to lower paying jobs in the informal sector.
Impact on education sector
• The education sector is also affected as AIDS claims the lives of teachers and
has contributed to serious teacher shortages across the world, especially in
Africa.
• Additionally, the disease continues to affect school attendance and enrollment
among children affected by HIV/AIDS.
Impact on People Living with HIV/AIDS (PLWHAs)
• There are adverse consequences for people living with HIV/AIDS (PLWHA),
which include stigmatization and discrimination.
• It is also common for people with HIV to lose their income as their health
deteriorates and are unable to work.
• Sometimes, people with HIV are abandoned by their families and forced to live
in isolation and destitution.
STIGMA AND DISCRIMINATION
• Stigma is bad feelings towards people who may be different from what others
think is right or normal.
• It’s a mark of disgrace or dishonor that sets a person apart from others
• When a person is labelled by their illness,they are no longer seen as an
individual but a part of a stereotyped group.
• Negative attitudes and beliefs toward this group create prejudice which leads to
negative actions and discrimination.
• Discrimination consists of actions or omissions that are derived from stigma and
directed towards those individuals who are stigmatized.It’s the unjust or
prejudicial treatment of different categories of people especially on the grounds
of their race,ethnicity,age,sex,economic status,disability,illness…..
• There is a lot of stigma and discrimination to people living with HIV/AIDS.
STIGMA
• Stigma has been described as a dynamic process of devaluation that
‘significantly discredits’ an individual in the eyes of others.
• The qualities to which stigma adheres can be quite arbitrary. For example, skin
colour, manner of speaking, or sexual preference.
• HIV-related stigma is multi-layered, tending to build upon and reinforce
negative connotations through the association of HIV and AIDS with alreadymarginalized behavior.
• Individuals living with HIV are often believed to deserve their HIV-positive
status as a result of having done something ‘wrong’.
• Stigma is expressed in language. Since the beginning of the epidemic, the
powerful metaphors associating HIV with death, guilt and punishment, crime,
horror and ‘otherness’ have compounded and legitimated stigmatization.
• HIV-related stigmatization, then, is a process by which people living with HIV
are discredited.
• It may affect both those infected or suspected of being infected by HIV and
those affected by AIDS by association, such as orphans or the children and
families of people living with HIV and AIDS.
DISCRIMINATION
• Discrimination against People Living with HIV, refers to any form of arbitrary
distinction, exclusion, or restriction affecting a person, usually but not by virtue
of an inherent personal characteristic or perceived belonging to a particular
group.
Causes of HIV-related stigma
• Ignorance or insufficient knowledge, as well as misbeliefs and fears about HIV
and AIDS.
• Moral judgements about people and assumptions about their sexual
behaviour.
• Associations with ‘illicit’ sex and/or drugs.
• Fear of death and disease.
• Links with religion and the belief that AIDS is a punishment from God.
Types of HIV/AIDS-related stigma
• Self-stigma is, for example, self-hatred, shame, blame etc. Self-stigma refers
to the process whereby people living with HIV impose feelings of difference,
inferiority and unworthiness on themselves.
• Felt stigma are perceptions or feelings towards a group, such as people living
with HIV, who are different in some respect.
• Enacted stigmas are actions fueled by stigma and which are commonly
referred to as discrimination.
Self-stigma
Manifestations of self-stigma include:
• feelings of shame, dejection, self-doubt, guilt, self-blame and
inferiority;
• feeling that the person deserves to be in that particular situation;
• loss of self-esteem and confidence;
• social withdrawal and isolation;
• no longer dining with or expressing physical affection towards
partners and family members;
• self-exclusion from services and opportunities, and refusing help that
is offered;
Felt stigma
Stigma can be blatant or subtle, but it is always value-laden and compromises
the human rights of those affected.
Stigma is characterized by denial, ignorance and fear. Other features of stigma
include:
• pointing out or labelling differences – "they are different from us";
• separating 'us' and 'them' – leading to avoidance, shunning, isolation and
rejection;
• stereotyping;
• attributing differences to negative behaviour – "his sickness is caused by sinful
or promiscuous behaviour";
• loss of status;
• overt abuse (may occur).
Enacted stigma
The effects of stigma are wide-ranging and may include actions taken by the
person concerned in response to the stigma, and actions taken against the
person concerned, which are discriminatory.
Felt and enacted stigma can take many forms such as:
• physical and social isolation from family, friends and community;
• being kicked out of one's family, house, rented accommodation, school, and
community groups;
• gossip, name-calling and insults;
• judging, blaming and condemnation;
• loss of rights and decision-making power;
• stigma by association – e.g. the whole family is affected by the stigma;
• stigma by looks/appearance/type of occupation;
• loss of employment;
• impaired access to treatment and care;
• dropping out of school;
• depression, suicide, alcoholism;
• avoiding getting tested for HIV;
• break-up of relationships;
• violence;
• loss of perceived ‘manhood’ or ‘womanhood’
Types of HIV/AIDS-related discrimination
• A country’s laws, rules and policies regarding HIV can have a significant effect
on the lives of people living with the virus.
• President Museveni of Uganda supports the national policy of dismissing or
not promoting members of the armed forces who test HIV positive.
• The Chinese government advocates compulsory HIV testing for any Chinese
citizen who has been living outside of the country for more than a year.
• In healthcare settings people with HIV can experience stigma and
discrimination such as being refused medicines or access to facilities, receiving
HIV testing without consent, and a lack of confidentiality.
• In the workplace, people living with HIV may suffer stigma from their coworkers and employers, such as social isolation and ridicule, or experience
discriminatory practices, such as termination or refusal of employment
• Restrictions on travel and stay
• Deportation of people living with HIV has potentially life-threatening
consequences if they have been taking HIV treatment
• Community-level stigma and discrimination can manifest as ostracism
(isolation), rejection and verbal and physical abuse.
• Stigma and discrimination can also take particular forms within key
populations at higher risk e.g gay HIV +ve.
• Families play an important role in providing support and care for people
living with HIV and AIDS. However, not all family responses are supportive
Effects of Stigma and Discrimination in HIV prevention
• There are many direct and indirect links between the HIV epidemic and lack of
protection of human rights.
• Violations of rights may worsen the impact of HIV, increase vulnerability, and
hinder positive responses to the epidemic.
• A stigmatizing and discriminating environment has devastating consequences in
terms of preventing the spread of HIV/AIDS amongst specific population groups.
• Stigma and discrimination act as impediments to uptake of HIV testing, treatment
and care and to adherence to treatment.
• A consistent, negative association has been found between fear of stigma (or
perceived stigma) and use of testing and treatment services.
• Stigma and discrimination are associated with lower uptake of HIV preventive
services, including under- or non-participation in HIV information meetings and
counselling and reduced participation in programmes to prevent mother-to-child
transmission.
• Stigmatizing attitudes are associated with denial of risk and a lower likelihood of
adopting preventive behaviours
• Fear of stigma impedes prevention efforts, including discussions of safer sex and
preventing mother-to-child transmission. Because of the separation between 'us' and
'them', people avoid confronting their own risk and adopting preventive behaviours.
• Impact: The violation of human rights encapsulated in discrimination increases the
impact of the epidemic on people living with HIV and those presumed to be infected,
as well as their families and associates.
• Vulnerability: People are more vulnerable to infection when their civil, political,
economic, social or cultural rights are not respected.
• Gender: The impact of HIV/AIDS-related stigma and discrimination on women
reinforces pre-existing economic, educational, cultural, and social disadvantages and
unequal access to information and services.
• Racial and ethnic stigma and discrimination contribute to the marginalization of
minority population groups, increasing their vulnerability to HIV/AIDS
• Disclosure: stigma and discrimination adversely affect disclosure to partners,
health care providers and family members.
• Postponement or Rejection of Treatment, Care and Support: Stigma may also
compel people to conceal medicines, which may result in inconsistent doses
• Resources like medicine, transport to health services, food and other amenities
may be withheld because of a perception that people living with HIV are
hopeless cases and will die anyway.
• Utilization of voluntary counselling and HIV testing (VCT) services and
disclosure of HIV status are constrained because of the anticipated stigma and
the actual experiences of people living with HIV.
• Response: Where human rights are not respected, for example when freedom
of speech or freedom of association is curtailed, it is difficult or impossible to
mobilize an effective response to the epidemic.