Stigmatising HIV

thousands, Mhaka claimed asylum and this was refused.
He has exhausted all options to plaster his application in order to be re-considered by the Home Office (Home Affairs Ministry) and on this chilly Thursday afternoon he visits a charitable organisation supporting asylum seekers, or otherwise face a raw deal from the government here.

Mhaka has come to ask if the charity can make representations on his behalf so that the Home Office can agree to find him accommodation locally than to be moved 200 km to the north of the country, far away from his established social network. His main reason, which is acceptable to the Home Office, is that he is seeing a consultant as he has a diagnosis of HIV.
The government here is sympathetic to asylum seeking individuals with life limiting conditions when it comes to ascertaining whether they can arrange to accommodate them where they prefer to be.

Otherwise applicants have to accept what they are offered with very limited choice.
To limit the choice, legislation was enacted declaring that the Secretary of State (Minister) has ‘power’ to assist asylum seekers. As a consequence, asylum seekers live literally from hand to mouth and it is all the more difficult if their case has been refused.

By contrast the Secretary of State has a ‘duty’ to provide locals with relevant Social Services benefits. For individuals with underlying health conditions such as HIV, the government can be sympathetic. I have picked Mhaka’s case to highlight the variation of how individuals with HIV are perceived socially and institutionally.
Academically, as human beings we are all socialised to understand different issues based on our cultural, social and political circumstances. It is that socialisation that presents difficulties for health promotion programmes to succeed, especially with regard to breaking down stigmas, largely associated with such conditions as HIV.

It is difficult to provide an analogy of the experiences of individuals with HIV in the UK society and Zimbabwe as other variables are different. But what sticks out is that in Zimbabwe there is a tendency to be socially and casually derogatory to individuals with visible evidence of an underlying health problem. And by default, this is tantamount to celebrating the potential aggregate life loss due to the terminal illness.
In the UK the situation is different for many different reasons. Needless to mention that the stigma associated with HIV is also rampant, particularly given coverage in the news media, which is largely negative. Newspaper headlines highlighting somebody has HIV would give the impression that this is a dominant infection in the UK and yet official statistics give a very different picture. In other

words, for individuals with HIV it is vital to follow the social model.
This model has been successfully used by physically disabled people, who have argued that it is not their disability which stresses them more, but social prejudices. Under this model, it is society, which should make reasonable adjustments for them to realise their potential and live as normal a life as possible.
For example, there have been reports in the newspapers about some people being fired from their work after authorities discovered they were HIV positive. This in the face of evidence of how the virus is passed on, is clearly discrimination, which only serves to reinforce the negative stereotypes, which are dominant. In the UK individuals can only share information with regard to status on a need to know basis. Individuals may not feel the daily prejudices they experience abroad, but a more difficult aspect to the issue here is more structural.

From a structural point of view, the government here associates HIV with foreigners, especially those domiciled in Sub Saharan Africa. Yes statistics do point out that is the worst affected regions on the planet. The Department of Health here also associates the contact with foreigners as a source of infection for locals. In other words Brits who have been abroad are more likely to acquire the infection. In the UK as of 2009, the latest year for which statistics are available, an estimated 86,500 people were living with HIV.

The figures do not distinguish how many people are living with HIV but this number combines the 64,300 people diagnosed with HIV with an estimated 22,200 who were infected but undiagnosed. In 2009, an estimated 30,188 black Africans were living with HIV in the UK. This includes over 23,288 diagnosed people accessing HIV care and a further 6,055 estimated to be undiagnosed.
In 2009 there were 23,288 black African people in the UK living with a diagnosed HIV infection and accessing HIV care.

The number of HIV positive black Africans accessing HIV care increased from 4,920 in 2000 to 23,290 in 2009. This is an increase of nearly five-fold compared with an overall increase of three-fold in the number of people accessing HIV care in the UK over the same period of time.

The overall proportion of people living with HIV in the UK is estimated to be 0.14 percent, or 1 in 714. The proportion of men living with HIV in the UK is estimated to be 0.19 percent, or 1 in 520, while the proportion of women living with HIV in the UK is estimated to be 0.09 percent, or 1 in 1111. The UK population is about 62 million. According to official statistics, the number of people accessing HIV specialist care has increased every year in the last decade, from 20,099 in 1999 to 65,319 in 2009. This is an increase of over three-fold. Clearly HIV is becoming an issue, but it is viewed within the context of the overall objective to improve the well being of the population.

Having said that, it will suffice to point out that institutions do not in essence see anything peculiar about HIV, apart from it being one of the many life limiting conditions that are available in life. Here other conditions that are more dominant are cancer and heart disease, contrary to the situation in Sub Saharan Africa.
In 2009 less than one percent of people with HIV died. This is about the same as for the UK population as a whole, However, the average age at death of people living with HIV is lower than that for the general population. Nevertheless, somebody newly diagnosed with HIV today can expect a near-normal life expectancy if they are diagnosed early and receive treatment.

Although more and more people now have HIV, improvements in testing and advances in available treatment mean that the proportion of deaths among people with HIV has fallen considerably.
It is normal for people in society to use humour as a way of expressing reality. By this I mean it is common for people to actually jokingly say something and yet it is the truth expressed in a light hearted manner. In the Zimbabwean society, people have created expressions and words that undermine the emotional well being of those living with HIV. For example, people say: “akarohwa nematsotsi.” Or “ave kuzviitira mazuva ano.” The problem is that symptoms are quite visible for most and others make fun of it to the detriment of their emotional well being.

Needless to mention that in the social context of the joke, nobody knows whether the person you are talking to has HIV and by default could be feeling the negative impact of the supposed joke.
I therefore condemn any humour, which is related to HIV as this is unhelpful to the well being of someone with this life limiting condition.
I suppose the stigmatisation of HIV is essentially the problem and I know the government has invested money in trying to sensitise people to what the condition is all about.