Blame & Banishment - Médecins du Monde

Blame and Banishment: The underground HIV epidemic affecting children in Eastern Europe and Central Asia
In general terms, responsibility for the spread of HIV is seen to lie exclusively with those
who are infected, who must then assume the consequences of their acts – a mindset that
also provides the rationale for criminalization of HIV transmission. People living with HIV are
viewed as ‘sources of infection’ that need to be controlled and having little to contribute to
society. The idea that the epidemic can be better contained by supporting those at risk or
living with HIV is a new one, and only slowly gaining ground.
Irina’s hard choice...
For most people an HIV-positive diagnosis results in deep shock. Stigma and exclusion often undermine the essential support that family
members can provide at this time of greatest need. The story of Irina is one example:
Irina, a young woman from Ukraine, used to inject drugs. She managed to stop using drugs and got married. Because of the stigma
surrounding drug use, she chose not to tell her husband about her past life. Soon afterwards, she became pregnant.
An HIV test at the antenatal clinic revealed she was HIV-positive. The news came as a great shock. Again, because of the stigma
associated with HIV, and fear that her husband would leave her and her children, she chose not to tell him about the diagnosis. Irina
secretly took antiretroviral (ARV) prophylaxis to prevent HIV transmission to her baby. Her child was born free of HIV.
Three years later when she became pregnant again, her immune system was found to be depressed. The doctor recommended that she
initiate highly active ARV treatment, both for the sake of her own health and that of her future child. This meant that she would have
to bring home large quantities of ARV medications to take every day. Irina refused. She was too afraid that her husband would realize
that something was wrong and would find out that she was HIV-positive.
Despite numerous sessions with health-care workers, psychologists and peer counsellors, Irina would not change her mind. Her main
concern remained that her husband would leave her, and that her children would then lose not only their mother but also their father
and might end up in an institution.
Irina gave birth to twins. Both were HIV-positive.
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