- prepared to support fight against stigma and discrimination
With a one percent Human Immunodeficiency Virus (HIV) prevalence, Guyana has done an admirable job in managing its national HIV/AIDS programme. This is the assertion of Resident Representative of the Pan American Health Organisation (PAHO), Dr William Adu-Krow.
“I think a lot has been done to bring the prevalence to where it is and therefore it (the programme) has been managed well,” said Dr Adu-Krow during an interview with this publication. And it was because of such an achievement, he noted, that the United States President Emergency Programme for AIDS Relief (PEPFAR) has been winding down.
According to Dr Adu-Krow, who is relatively new to the position of Resident Representative here, Guyana has been able to do a great deal in terms of raising awareness regarding the facts and myths relating to HIV/AIDS.
However, there is yet work to be done, he noted, since there are persons such as Men who have Sex with Men (MSM) and Commercial Sex Workers (CSW) who are still marginalised in the society.
“Once society doesn’t accept them they hide and therefore it is difficult to treat them,” said Dr Adu-Krow, as he alluded to stigma and discrimination as one of the major issues that has long been threatening to hamper the gains made in the HIV/AIDS fight.
Among those mostly discriminated against, he noted, are those who engage in homosexual lifestyles. He disclosed that while there are organisations, some local, that were established specifically to advocate for the rights of such individuals, there are still some who cannot afford to come into the open for fear of discrimination.
“If they can’t come out to the open, they cannot be treated (if they are infected), if they cannot be treated then the viral load (the amount of HIV in the blood) that they have might be so high that they can transmit the virus,” Dr Adu-Krow observed.
He is therefore of the belief that there may be a great deal of persons still living in the shadows because of their sexual orientation and therefore may not be aware of their HIV status.
Moreover, the PAHO Resident Representative has concluded that “we have got a lot more work to do on this issue of stigma and discrimination, especially with the marginalised population.”
Although many are convinced that homosexual tendencies come down to an individual’s personal choice, there are many who are unwilling to openly reveal their status in light of the fact that such lifestyles could be punishable by existing laws, with men who engage in homosexual relations and cross-dressers being specifically targeted.
But according to Dr Adu-Krow, “if we have incriminating laws whereby if you are a homosexual you can be imprisoned, the people are not going to come out to be tested for you to realise that they are homosexuals who may have HIV too.”
There have been continuous calls for the repeal of the existing legislation, a move the PAHO Representative intends to support.
“The advocacy has started, even before I came, because at the last meeting with Global Fund it was decided we needed to look at those laws and see how best legislation can come and assist us, because the more you incriminate them (homosexuals) the more they go underground and their viral load will increase in their system,” disclosed Dr Adu-Krow.
Global Fund is an international financing organisation that disburses resources globally to prevent and treat HIV/AIDS, tuberculosis and malaria. For a number of years, Guyana has been a beneficiary of the Global Fund disbursements.
According to the PAHO Representative, in light of the fact that stigma and discrimination is a hindrance to progress, efforts must be channelled to ensuring that it is not permitted, as far as possible. He made reference to early fights against tuberculosis and leprosy, both of which were affected by stigma and discrimination, thereby resulting in persons refusing to be tested. “Once you open up to these people they feel free to come and get tested and get medications so that they can prevent themselves and other people from getting the disease. So there is no doubt we still have work to do,” Dr Adu-Krow asserted.
Moreover, he is calling for efforts to be made to reach out to religious bodies to help reduce existing levels of stigma and discrimination. He noted that “normally institutions are the last groups to embrace change; individuals do change, but institutions I think are very dogmatic, so we have got to work through churches and gradually get them on board.”
And although churches may not be willing to accept certain lifestyles, Dr Adu-Krow has warned that efforts must be made to guard against shunning persons.
“From a PAHO/WHO standpoint, we need to work with all individuals without discrimination because we know we all have our own choices to make at the end of the day.”