Bajan stigma keeps HIV alive
“I don’t like speaking about AIDS, because there is no reason to have it in this country; none whatsoever. We have all of the drugs and treatments available,” Director of the HIV Laboratory, Dr Clive Landis, declared about Barbados.
The former chairman of the Barbados National HIV/AIDS Commission’s Research Committee made that declaration during a lecture Tuesday at University of the West Indies, Cave Hill Campus.
He explained that his confidence was based on public knowledge available on the risks of contracting this dreaded illness, and the ready availability of medication to effectively reverse the disease to the extent that it becomes non-infectious.
Dr Landis established that the Health Ministry has long recognized that not only does the quality of anti-retroviral drugs – available for more than a decade – have the ability to treat the patient, but that constant application of the medication reduces the viral load in infected persons to the point that they are no longer infectious and could live normal lives.
But his statements during the presentation and comments from the floor after the talk, revealed the reason AIDS still exists in Barbados today – stigma. And health workers have been identified as among the chief offenders.
“HIV came with an avalanche of fear. It was a death sentence, and healthcare workers have continued to stoke that fear knowingly, or unknowingly,” Dr Landis said.
He explained that United Nations reviews found that with the identification of HIV/AIDS in the early 1980s, the approach by health workers was to provoke urgent action among nations.
“It was intended to cause fear, so that lots of money could be raised from governments to tackle this disease,” Dr Landis said.
However, he contended, “we’ve long past the point where we need to be afraid of this disease. It’s not a death sentence. It is very difficult to catch.”
The key, he said, is diagnosis and treatment.
Dr Landis noted that in Barbados, the easy access of treatment should mean that the disease is near eradication, but that is not the case because of the social obstacles between infected persons and much needed care.
“There are barriers keeping the patient apart from the drugs,” he said.
“It is the diagnosis which we need in the first place, and then the linkage to care, and what’s hindering that is fear and stigma.”
In contributions at the end of Dr Landis’ presentation, a number of medical professionals in attendance conceded that some of the practices of colleagues generate stigma and create the fear that keeps people from seeking diagnosis.
One doctor even talked about healthcare assistants and orderlies loitering outside treatment centres to see who was turning up for diagnosis.
Dr Landis said that overcoming the fear of being pointed out as an infected person and obtaining the diagnosis is just one of the barriers.
“Once you’re linked to care and you’re on the drugs, you need support. These drugs, you have to take them religiously. You need to adhere . . . but instead what many patients get is discrimination and isolation.”
While making it clear that attitudes of discrimination and isolation can be found right across the Barbadian public, Dr Landis brought home to the professionals present in the lecture theatre, the error of their ways.
“We always like to blame someone. Who’s placing the barriers in the way? Who’s putting the uninfected population at risk? It’s all of us, it’s you and me, everyone in this room, because it is our own thoughts, our own attitudes, very often our words.”
He continued: “This has now become the principal determinant of whether an HIV infected person will know their status and have access to anti-retroviral medication, have suppressed virus or have very high virus level, be non-infectious or highly infectious; whether HIV would be suppressed in the population or whether it will spread in the population.”
Given these existing circumstances, Dr Landis asked, and answered, “Who is placed at risk by our own attitude of stigma and discrimination? It’s us”.
The 2009 awardee of the Professional Chair of Vascular Research at UWI, Cave Hill, said: “When we express scornful attitudes, or place barriers in the way of persons to know their status or to receive anti-retroviral treatment, we place ourselves at the risk of HIV infection.
“On the other hand, if we were to take a caring and compassionate approach to a person with HIV, they are more likely to know their status, to seek treatment; more likely to have the virals suppressed in their body. Then we, the public, would have made ourselves safer from the risk of HIV infection.”