15 June 2011

Stigma and ignorance in Africa

Africa has suffered more from the scourge of Aids than anywhere else on earth since the first case of HIV was diagnosed three decades ago.


Africa has suffered more from the scourge of Aids than anywhere else on earth since the first case of HIV was diagnosed three decades ago.

The continent's sub-Saharan countries are the worst effected, with the region now home to 22.5 million of the total of 34 million people currently living with the virus that causes the disease.

But those working at the coalface of the epidemic not only have to look at getting people on treatment and ensuring that affordable anti-retroviral (ARV) medicines are available, they also have to ensure that those infected with HIV aren't shunned because of ignorance and fear.

One man’s story

The story of Kenyan Gabriel Owiyo is commonplace in Africa. Six years ago, he worked on the sugarcane harvest in the west of the country. The labour was hard but well paid and he often celebrated his evenings in the company of prostitutes, who had travelled to the area from other parts of Kenya in search of business.

Like most of his friends, Owiyo never bothered with a condom during sex as he considered such use as "unmanly" even though there was a significant anti-Aids campaign underway throughout Kenya at the time.

When the then 26-year-old suddenly began to suffer from fever and lost a significant amount of weight over a short period of time, he knew it was probably the virus that causes Aids.

Rumours started going around the neighbourhood that he was infected but he refused to go for a test.

Suppressing the truth

"As long as I didn't know what was wrong, I was able to suppress the truth," Owiyo explains.

He continued to have unprotected sex with his wife but it was only when she became pregnant that he began to panic.

"I heard about the infection that the virus could be passed on to a child."

Owiyo allowed himself to be tested and it came up positive. His wife, however, was HIV negative but the shock was still immense.

"It was terrible when the truth finally came out," says Owiyo, who now works on an anti-Aids campaign in the Kakamega region as well as leading a self-help group for men affected by the disease.

"I was weak, nothing more than a skeleton, and could do nothing more than lie in bed. People asked my wife when would I finally die," he said.

"One of my brothers broke off all contact because he was ashamed of me. No one wanted to sit in the same pew as my mother at church and nobody at the market wanted to sell vegetables to my wife."

Upper hand

The stigma that accompanied the disease affected his entire family. Owiyo was fortunate enough to receive anti-retroviral treatment, which has worked well and, today, the 32-year-old has the upper hand on the disease.

"I am now able to meet people and tell them to go and get tested so that they they can do something about it. Aids does not have to be a death sentence anymore."

Since scientists in the United States reported the first clinical evidence of Aids in June 1981, the Aids epidemic has scarred life in Africa.

Women are more likely to be infected than men, with the figure rising to 70% in some sub-Saharan African countries.

Maternal duty passed on to daughter

As women are almost exclusively responsible for raising children and household work in rural African areas, if they are too weak to work or die from Aids, then it is the responsibility of a daughter to leave school if need be to take over the maternal role.

For many years, the impact of Aids on African society was played down, especially in the south of the continent, but this is changing.

"South Africa has only 0.7% of the world population while carrying 17% of the HIV/Aids burden of the world," says Health Minister Aaron Motsoaledi.

In neighbouring Botswana, Lesotho and Swaziland nearly a quarter of all adults are infected while, according to United Nations figures, around 22.5 million people in Africa have HIV.

Better access to ARV drugs has led to a drop in the mortality rate from Aids in recent years but there is no reason to be complacent.

(Sapa, Eva Krafczyk and Laszlo Trankovits, June 2011)

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Dr Sindisiwe van Zyl qualified at the University of Pretoria in 2005. She is a patients' rights activist and loves using social media to teach about HIV. She is in private practice in Johannesburg.

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