Missing the Target #5: Improving AIDS Drug Access ... - CD8 T cells

and socially disadvantaged, lacking equal access to treatment, financial support,and education. In a number of societies, women are mistakenly perceived as themain transmitters of STDs. Together with traditional beliefs about sex, blood, andthe transmission of other diseases, these perceptions provide a basis for the furtherstigmatization of women within the context of HIV and AIDS. Men are likely to be”excused” for the behavior that resulted in their infection, whereas women are not.Manifestations of stigmaKENYAStigma towards PLWHAThis study found that PLWHA are treated differently, gossiped about, deprived oftheir identity and roles, and often denied their own resources.The most common forms of differential treatment are physical or social exclusionfrom the family and community, which may also include denial of care and supportby the family, community, and health system. Those infected sleep separately, useseparate beddings and linen, and at times use separate utensils. Social exclusionusually manifests itself as the reduction of daily social interaction with family andneighbors, and exclusion from family and community events.Gossip—and the fear of gossip—is pervasive. PLWHA are talked about negatively,and this may be the most common and feared manifestation of stigma. Gossiphas a greater impact on women than men as women usually have a greaterdependence on social networks. The targets of gossip also lose their identity andsocial roles, as they are considered to have no future and are no longer productive.Stigma and discrimination also manifests through loss of access to resources andlivelihood. Workplace stigma may result in job loss when the HIV-positive person islaid off, and HIV-positive business and trades people are likely to lose customers.Worse yet, an HIV-positive person may lose his or her property rights within thefamily, and HIV-positive women may lose their inheritance.The internal stigmaPLWHA were also found to internalize the stigma. The feelings of helplessnessand that death is imminent can be debilitating. PLWHA may internalize the guiltand blame for being HIV-positive and accept their inferior status in society.Psychologically affected by stigma, they can become despondent and lose hope,and may isolate or separate themselves and even give up on previous lifeaspirations. This form of stigma is devastating because it bars people who alreadyknow their status from seeking care and treatment, and also prevents those withadvanced stages of AIDS from seeking care.“If I’m tested and found to be HIV-positive, I will commit suicide.”—A person with late-stage AIDS, who has since died of complications due to AIDS.32