HIV/AIDS and the Cost of Stigma

As Nigeria, today, joins the rest of the world to commemorate World AIDS Day, Martins Ifijeh writes on the pain and frustration of people living with the virus due to stigmatisation and discrimination from the society despite the laws criminalising discrimination against persons afflicted by the disease in the country

“Please, don’t use my son’s first or last name in your interview. Try also not to describe him at all so that his school won’t suspect he is living with Human Immuno Virus (HIV), because it took us almost two months after schools resumed in September 2015 before we could secure a school for him in this area.” These were the exact words of the mother of 12-year-old Caleb (not real name), who believed her child and the entire family have had their fair share of stigmatisation and discrimination due to their status as persons living with HIV in Lagos State.

She said when Caleb, who is presently in JSS 2 finished his primary school last year, they tried to get him into a good private secondary school within their area, but were at each occasion subjected to medical examinations which gave the schools idea of what he was living with, and then the subsequent rejection.

“The two good secondary schools around rejected him because of his status. While one outrightly told us he would not be admitted based on that, the other simply used a subtle tactics by telling us that the slots for the year were filled up, and that was after we were already given list of resumption materials to buy and how much to pay. They even admitted other children after they had told us their slots for the year were occupied.”

This led Caleb’s parents to seek for a school where medical examination was not a criteria for admission. However, they have continued to keep his status as a top secret from his current school, believing that if the school eventually finds out he was living with Nigeria’s most feared virus, he may be asked to stop coming to classes.

The school scenario is not the only battle the family has had to fight for societal acceptance. They moved from their previous house because, somehow, a neighbour who was a laboratory technician with Lagos University Teaching Hospital (LUTH) mistakenly saw the family’s Anti Retroviral Drugs, and then leaked it to other neigbhours in the compound.

“We really never felt the pressure of living with the virus since doctors had told us that with the appropriate use of the ARD, myself, my husband and our three children would lead normal lives, but the stigmatisation, the shaming and discrimination from our neigbhours became our greatest torment. In the compound, we quickly became outcasts.

“We had to hastily look for another apartment where we currently stay now, and it is outside our former vicinity, because we reasoned that as our neigbhours were increasingly discussing about it, other members of the community might just get to know, which in turn would mean we may not be able to walk around in the area,” she explained.

According to her, where they stay now is a different community entirely and no one knows if they are living with HIV or not. “Our children are very much aware of the society we live in, so they know how much they must keep their status as secrets,” she said, adding that, most people who lose their lives or become frustrated due to their status do so chiefly because of how the society view them, not because they believe the drugs won’t sustain them.

Caleb’s family is not the only one suffering from stigmatisation and discrimination due to their status. Rasheed, an unemployed graduate of Engineering, who otherwise should have been working in an oil and gas company at the Murtala Muhammed International Airport, Lagos, if not for his HIV status, is experiencing the worst form of discrimination due to the virus.

Rasheed was very close to clinching the oil and gas job haven gone through all the phases of interview with good outcomes, but was asked to go to a certain hospital, (probably the Health Management Organisation of the firm) for medicals. That was the end. His mates resumed the next Monday, while he never got a favourable response from the company after his results were sent from the hospital, directly to the company.

“After over 50 of us had done the written test, about 20 of us were later called back for oral interview. Before I left the airport that day, I was told I passed the oral test and that I should come back the next day for another round of the recruitment process.

“We were only eight that eventually made it to that phase. We were then asked to provide our drivers license, then were taken to an open field, where we were all tried on how to drive bowsers (Big tankers built specifically for fueling aircraft or supplying water). They needed only eight people, and I was told I did well during the test,” Rasheed explained.

He said when they were told to report at a certain hospital for medical examination, he feared the worse might happen as all his successes during the recruitment process might just be futile after all. His fear was confirmed as other seven engineers resumed the Monday after, except him.

It has been one year six months since the interview. Rasheed is still home looking for another job. This time he is hoping his next recruitment process would not involve undergoing medical examination. “In a country where jobs are scarce, will I ever get a near-close opportunity like the one I got at the airport, not to talk of getting a job that would be better than that?” Rasheed queried.

Caleb’s family and Rasheed are just two out of millions of HIV positive Nigerians who are going through the deprivation, torment and societal rejection occasioned by discrimination due to their HIV status. The over four million Nigerians living with HIV/AIDS are at one point or the other going through societal rejection, stigmatisation and discrimination, which experts have continuously stressed was the main killer of people living with HIV in Nigeria, and not the disease itself.

The narratives by the two accounts resonate the true picture of a statement made years ago by the Secretary General of the United Nations, Ban Ki-Moon, when he said; “Stigma remains the ugliest aspect of being a HIV/AIDS patient. It is the main reason many people are afraid to see a doctor to determine their status. It made AIDS a silent killer, because people fear the social disgrace attached to it. For this reason, AIDS epidemic has continued to devastate societies around the world.”

While Nigeria and other countries across the globe continue to make progress in the reduction of its incidence level, as well as death rates from the scourge, it is believed that stigmatisation and discrimination are chief factors militating against several interventions, especially from developing countries like Nigeria where stringent measures are not put in place to address the societal nuisance.

What the law says about stigmatising people living with HIV/AIDS
Shockingly, in an interview with THISDAY, the Chief Executive Officer, Lagos State AIDS Control Agency (LSACA), Dr. Oluseyi Temowo, said there exist an anti-stigma law criminalising stigmatisation and discrimination of persons living with HIV/AIDS, adding that persons or organisations caught were ideally meant to face the full rot of the law which could involve imprisonment.

He said LSACA has carved out a group which goes out daily to interact with persons living with HIV/AIDS and if during the cause of their job they come across persons living with the virus who are being stigmatised or discriminated upon, the agency takes it up to bring offenders to book by prosecuting them.

“There is a case recently of a young boy who was thrown out of the house by his step-mother because he is living with HIV. Even though we have provided shelter and other palliatives for him, we have instituted action against the said step-mother for discriminating against him.

“Another case is that of a student who after finishing his primary school, was rejected by the secondary school he sorted admission because they eventually discovered he was positively living with HIV. We went to the school, took it up with them, and the principal eventually apologised, while denying that he didn’t know the boy was rejected based on his status,” Temowo said.

Way forward
While frowning at the low general implementation of the anti-stigma law, Temowo called on Nigerians and persons living with HIV/AIDS to be fully abreast with the consequences of stigmatising people based on their status.

While reading the riot act to people still flouting the law, he said, “We need to scale up implementation of the law so that those who are caught and prosecuted will serve as a deterrent to other persons and organisations who are still stigmatising persons living with the virus.

“Going forward, I believe the media will be of great assistance in educating Nigerians on the fact that HIV is not a death sentence, and that PLWH can live normal lives, and must not be stigmatised against. They deserved to attend the schools other children attend. They deserved to work and live normal lives,” he stressed.

The CEO said HIV/AIDS prevalence was drastically reducing in the country, adding that the last national survey shows in 2014 that Lagos State HIV/AIDS prevalence has dropped to 4.0 per cent. “However, the state has been doing its pockets of survey lately, and the good news is that by our records, the prevalence has further dropped to about two per cent,” Temowo said.

He called on Lagosians to do their HIV screening, while engaging in lifestyles that would not put them at risk of the disease.