The AIDS crisis isn't over. Many people believe that it is, thanks to the availability of life-saving medication. However, only a third of the people who need the medication are actually receiving it. And the number who need it grows every year. In 2011, about 1.7 million people died from AIDS-related diseases, but 2.5 million people became infected by HIV, the virus that causes AIDS, a net increase of 800,000 people living with HIV.Yes, there has been tremendous progress in the medical and scientific aspects of HIV and AIDS. But there has been much less progress on the social aspects of the pandemic, especially the stigma associated with the disease. Why is stigma so important?
- The effects of the stigma on people living with HIV can be devastating -- societal rejection, loss of livelihood, even suicide. Fear of stigma keeps many people from getting tested and from receiving life-saving medication.
- The effects of stigma are so significant and widespread that it actually causes the disease to spread faster. The sad fact is that we have the medical tools to stop the spread of the disease, but we cannot take advantage of these tools when people are afraid to get tested and treated.
Fortunately, there is a solution. Leaders of local faith communities have substantial influence over the attitudes and behavior of the members of their faith communities and indirectly over the attitudes and behavior of the wider communities of which they are a part. When these leaders take action, stigmatizing attitudes and behavior change. Local faith leaders are uniquely positioned to eliminate stigma by taking action against it. In fact, we won't end the AIDS crisis without action by local faith leaders: An AIDS-free generation requires stigma-free faith communities.
In the past, faith leaders have often spoken about HIV as divine punishment for immoral behavior, despite the fact that many people living with HIV had no control over the circumstances of their infection (for example, women who are raped, children who are infected through their mothers). As the reality and scope of the AIDS pandemic became apparent, faith leaders often shifted toward silence -- HIV and AIDS became topics to be avoided because they are uncomfortable to talk about. While silence is better than overt judgmental preaching, silence does nothing to reduce stigma, and in fact, reinforces it.
So what actions can local faith leaders take? Several simple steps can go a long way toward reducing stigma:
• Educate the members about the disease. There is still a substantial amount of myth and misinformation about HIV and AIDS. Local faith leaders can spearhead educational campaigns to spread correct information about AIDS, HIV, treatment, modes of transmission, and methods of prevention.
• Emphasize compassion and acceptance of people living with HIV. In a previous blog, I described The Compassion Gap, a tendency to give messages of personal responsibility for avoiding infection much more often than messages of compassion and acceptance of those who are infected. While messages of personal responsibility are important, they often reinforce stigma. Emphasis on compassion and acceptance is required to combat stigma successfully.
• Acknowledge the distinction between the moral and medical aspects of HIV infection. Regardless of the mode of transmission, whether or not it involved behavior seen as immoral, a person living with HIV has a serious medical condition. For a person who has just learned that he or she is HIV-positive, the most important thing is acceptance and assistance with the day-to-day practicalities of living with HIV -- a lecture about why or how they became infected is counterproductive and even dangerous.
• Present personal testimonies by people living with HIV. Personal stories can be especially powerful because they put a human face on the disease. A Framework for Dialogue was recently launched by UNAIDS and other organizations to facilitate open discussion among faith leaders and people living with HIV.
• Encourage HIV testing for all members. If all members are tested, then the stigma associated with testing will be significantly reduced. Testing facilities can be set up near faith community gatherings, and the faith leaders can be the first in line to be tested.
We know that action by local faith leaders works. For several years, EMPACT Africa has been helping local pastors in southern Africa to eliminate stigma in their congregations. The results have shown that when local pastors take consistent and persistent action, stigmatizing attitudes are significantly reduced.
In many ways, the battle against stigma is the last battle of the war against AIDS. Fortunately, it is a battle that can be won -- all we need is for enough local faith leaders to take up the fight. If they do, then we can finally bring an end to the AIDS crisis.