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Eric Sawyer, an American living with HIV for many years and the Director of the HIV/AIDS Human Rights Project in New York, agrees. "Moral views can get in the way of common sense", he explains. "The people most visibly impacted by HIV at the beginning of the epidemic were gays, drug users, people having sex outside of marriage, and so on. It is difficult for most people, including those who make up a government, to discuss such issues as sex, drugs, homosexuality and blood." Sawyer also suggests that some decision-makers hold the view that "immoral" people are receiving just punishment for their behaviour. Alan Greig, whose work on HIV and AIDS has led him to Africa, Asia and Europe, takes up the thread: "In Cambodia, there is frequent talk of AIDS being symptomatic of the corruption of Khmer culture and having been brought to the country by United Nations peacekeepers in the early 1990s. There is much less focus on what the epidemic reveals about gender relations in Cambodia, the history of community dislocation and the mushrooming of the commercial sex industry with rapid economic development."
Schuyler Frautschi, based on his experience in the region, feels that there is hardly a government in Latin America or the Caribbean committed to helping change the way people think about the HIV epidemic, a strategy he considers necessary to an effective response. "The Government of Brazil", he says, "which took out a loan to offer a triple therapy of protease inhibitors to every person living with HIV in the country, may be an exception." Since Governments are made up of individuals, there is a link between the perceived denial behind governmental lack of action in response to HIV and people's seeming unwillingness to change their behaviour. "AIDS is still highly stigmatized in South Africa", states Barrett. "Very few people are willing to disclose their HIV status, and most are reluctant to discuss stigmatized topics like sex and death."
Njoko gives a painful example: "Recently, Gugu Dlamini was killed by neighbours in her village in South Africa because she was open about her HIV status. If I should die", she continues, "I hope my six-year-old son will not be attacked or stigmatized as an 'AIDS orphan' because his mother was HIV positive."
"People often expect simple answers to a complex problem", says Sy. "To understand the epidemic, we have to question ourselves permanently, how we treat people, our own behaviour, our self-esteem, and what we do both publicly and privately. We come to feel shame about many of these things, but it is often easier to deny it than to change." Sawyer suggests that denial can be due to internalized homophobia, in the case of men who have sex with men, or lack of self-esteem for many other people who do not protect themselves. "Many people feel subconsciously that they are not worth protecting, even when they know the facts", he adds. Sujata Rana agrees: "Many drug users, for example, are already so marginalized and despondent because of their dependency that they figure, 'so what if I die from HIV? I don't have any family or friends, anyway'." And it is human nature, she asserts, to take risks. Frautschi offers a similar explanation: "Human beings are complicated. All the information in the world hasn't helped enough when it comes to the risks of tobacco, alcohol and stressful jobs."
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HIV/AIDS IN THE WORLD:
DECEMBER 1998
Cumulative number of people infected: 47.3 million;
People living with HIV in 1998: 33.4 million;
People newly infected in 1998: 5.8 million;
AIDS deaths in 1998: 2.5 million;
Total number of AIDS deaths: 13.9 million.
(UNAIDS/WHO)
POINT OF FACT:
16,000 new HIV infections occur each day; 89% of people with HIV live in sub-Saharan Africa and Asia. In 1997, 1.6 million children lost their parents to HIV/AIDS.
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Number 1 1999
