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Combating stigma, isolation, stereotypes, and discrimination.

By showing, their own support and responsibility to care for all people, regardless of their health or social status, health care professionals can act as role models for others in helping combat stigma, discrimination, and isolation of people living with HIV/AIDS. Prevention strategies will become far more successful when HIV is treated like any other disease, and when people feel safe to be open about their HIV status. However, health care professionals can become advocates for acceptance and care only if they look inward and first examine their own beliefs, values, assumptions, and attitudes towards HIV/AIDS. This can be done individually or in groups by asking and reflecting on the following questions (WHO, 2000a:6-5):

• What fears or misunderstandings do I have?
• How might these fears misunderstandings affect my work?
• Where do these fears or misunderstandings come from?
• How can I overcome these fears or misunderstandings in order to provide care support, counselling, education, and advice in the prevention and care of HIV/AIDS?
• What influence do I have on others who care for people who are infected and affected by HIV/AIDS?
• What is my role in providing and promoting safe, moral, and ethical care to people living with HIV and their loved ones, caregivers and communities?

 Health care professionals should also think about and listen to the language they use when they speak: prejudiced language may alienate them from their target group. While saying ‘He caught AIDS’ and ‘He has AIDS’ may mean the same thing, the first sentence is loaded with negative meaning that betrays the implicit attitudes of the speaker. (Such a negative meaning may be that AIDS is something that we the, innocent, have no control, something that we ‘catch’ from ‘them’ – the contaminated ‘others’) People often say ‘He is HIV’ instead of ‘He is HIV positive’. A sentence constructed like this implies an identity with the virus, i.e. the person is the virus instead of the person has the virus.

 AIDS educators should also be careful not to use sexist language. Always to refer to he and him in the context of HIV/AIDS may imply that men are always the ‘guilty’ party. Victimising language should also be avoided. Instead of saying, ‘She suffers from AIDS’ one should rather say ‘She lives with AIDS’ or ‘She is HIV positive’. Rather than referring to ‘rape victims’ use positive language and refer instead to ‘rape survivors’. Be careful not to fall into the trap of using prejudiced or discriminatory language. If you refer to people with HIV infection as ‘those people’, you are clearly dividing the world into two groups: the innocent, healthy us and the guilty diseased them.

While we all sometimes think in terms of stereotypes, we should make every effort to be aware of our own stereotypes so that we can root them out and thus avoid offending others and hurting feelings. If we interact with a group, we will quickly learn to recognise our own prejudices and eliminate them.

The irrational and often exaggerated fears associated with HIV/AIDS can be directly addressed through educational programmes based on sound medical, social, and psychological knowledge.

To be successful, such programmes must be sustained and supported over time. Prevention strategies will continue to be compromised if fear, ignorance, intolerance, and discrimination against HIV-positive people persist. Healthcare professionals have a responsibility to help ‘normalise’ HIV in the communities where they work so that modes of transmission and prevention can be addressed without the emotional and attitudinal values that are currently getting in the way of open dialogue.

Counsellors and other healthcare professionals should not only ‘advocate for Universal Precautions, but also tolerance and knowledge about HIV/AIDS’ (WHO, 2000a6-4).

 (HIV/AIDS Care & Counselling – Alta Van Dyk 4^th Edition 132-133)