Health Workers Lead Fight against HIV-Related Discrimination

By Dr. Mirta Roses

Science has yet to find a cure for AIDS. But there is a cure for discrimination. It can be found in the thousands of health workers in the Americas.

WASHINGTON, Dec 1 (IPS) - HIV/AIDS has become the biggest threat to human survival in the last 700 years. Important gains made in child health and life expectancy in the Americas are being threatened by this epidemic, which is destroying many of the efforts and investments of past decades. It is already emerging as the leading cause of death in some countries of the region for people aged 15 to 44.

One harmful effect of the epidemic, which also acts as a barrier against prevention efforts, is discrimination against people who live with the virus. This discrimination can take despicable forms. Many people are turned away from schools on the basis of their HIV status, denied housing and shunned by friends and colleagues. Some even suffers physical violence. These actions are often extended to their families and communities and even to orphans whose parents died of AIDS. Worse, they can keep people from getting the treatment they need.

In part this discrimination derives from the understandable fear of a virus that is transmissible, incurable and potentially deadly. But we have learned a lot since the beginning of this epidemic.

Today there is widespread awareness that the virus cannot be transmitted through everyday contact. Most people know that there is nothing to fear if they adopt basic precautions. They know that is no reason to keep a distance from people with HIV.

Discrimination against people with HIV persists because it has additional, deeply rooted causes. Among them is the prejudice against groups hardest hit during the early stages of the epidemic, such as men who have sex with men, sex workers and drug users.

Segregating these already stigmatised groups allows some people to feel invulnerable to HIV. It provides an excuse for them to neglect to take those basic precautions. It is an irony of tragic consequences: The ones who most discriminate are precisely the ones less likely to protect themselves against HIV transmission.

In many countries, heterosexual transmission and female rates in general population are now the highest.

When discrimination against people with HIV creeps into health services the consequences can be very serious. Discriminatory health practices include refusing to treat people on the basis of their HIV status, testing for the virus without people’s knowledge or permission, and supplying names of people with HIV to others.

Sometimes this discrimination is barely noticeable, like when health workers have an uncaring attitude towards people with HIV. This practice is extremely harmful, because fear of mistreatment prevents people from using health services when they most need them.

Combating discrimination does not mean that differences should not be acknowledged. It only means that different treatment must be based on objective and reasonable criteria, intended to rectify, not exacerbate, inequities within society.

Health workers need all the support we can muster for the difficult task of caring for people with HIV and AIDS. Some of them need help to overcome their own prejudices. Others may need assistance in dealing with fear, coping with the stress of caring for the very ill and to prevent the emotional detachment that can occur among those who look after patients dying of AIDS. Caregivers also deserve the necessary training and resources to assure that the risk of accidental transmission of the virus is kept to a minimum.

Most health workers do not need any external encouragement to be on the front lines in the fight against discrimination against people with HIV. They do it because of their duty to improve health, their mandate to nurture, and their oath to take the necessary risks to care for fellow human beings. These and other public health interests provide a compelling justification for identifying and eliminating discrimination on the grounds of HIV status.

It is important to recognize the dedication of the thousands of health workers in the Americas who are striving both to provide good health care and to combat discrimination against people with HIV. We need to show special appreciation for the altruism and the courage of many doctors, nurses, laboratory workers and other staff who joined the response to the epidemic in its early stages. Their commitment to care for people with AIDS overshadowed the danger of catching an unknown disease. Their determination to serve overcame any alienation they may have suffered vis-à-vis their own colleagues.

The daring example of these pioneers is proof that health workers are set to play a leading role in the community and in society in building a supportive, non-discriminatory environment for people with HIV.

Dr. Mirta Roses, an Argentine physician and Assistant Director of the Pan American Health Organisation (PAHO), has been elected by the 26th Pan American Sanitary Conference for a five-year term as Director of PAHO, starting in February 2003.