Fighting HIV Stigma

Last week I attended the last meeting of the year of the Palawan Provincial Implementation Team Reproductive Health Council, which also serves as the province’s Local AIDS Council.

It is always a pleasure to be in the same room as my Provincial Health, PDOHO, PSWDO and Ospital ng Palawan colleagues as it is energizing to be around such passionate individuals working so hard to improve the health of Palaweños.

But the meeting was also depressing, as we heard one heartbreaking story after another. We talked a lot about HIV because there have been some awful instances lately that show how stigma and discrimination towards HIV are hampering efforts to stop the spread of HIV.

I’ll be removing any identifying features from the stories I’ll share, to protect the identities of those involved.

The most shocking and sad story is that recently a young person living with HIV (PLHIV) committed suicide. The PLHIV whom I’ll call V was only 17 and though he tested positive for HIV, he had no opportunistic infections. Often PLHIV is more prone or susceptible to infections like pneumonia, tuberculosis and liver disease. V had none of that. V’s CD4 count was high, indicating they were quite healthy. V only needed to take their Anti Retroviral Therapy medications and V could have lived a long, productive, healthy life. But sadly, that was not to be.

Trying to help find support, a family member of V’s took their confidential HIV records, including the HIV-confirmatory test results to the municipal social welfare and development office, to the Mayor, and to other entities that often give financial support to people facing health problems. Soon everyone in the community knew V’s HIV status. The discrimination and stigma V faced, particularly from some members of their family, was so great that V felt overwhelmed, rejected, and all alone. V made some public Facebook posts indicating suicidal thoughts, but no one reached out to help. Tragically, V took their own life.

Another sad story is of a couple that found out they were HIV positive because their baby was diagnosed with the virus. The baby had been in and out of the hospital with pneumonia and was not responding to any medication. Doctors screened for HIV and found that the baby was positive. The baby’s parents were then checked, and they both tested positive also. Only then did the story come out, that one of the baby’s parents whom I’ll call B, had sold sexual acts like a teenager in order to have enough money to go to school. Even as I type this it breaks my heart. No one should have to sell sex to attend school. B must have contracted HIV at some point during those years, but never had any symptoms and didn’t know anything about HIV so didn’t think to get tested. B’s spouse was so furious when they found out. The spouse threatened to sue B and to leave B for doing those things and exposing them all to HIV. B breaks down every time B has a counseling session. B is so distraught and guilt-ridden and now lacking social and familial support.

A final story. A colleague of mine recently screened someone for HIV and the test came back reactive. The colleague explained the results to the person, whom I will call K. K lashed out. K was furious and insisted the results must be wrong and that K would sue my colleague for giving the wrong result. K left without taking any information about how to access treatment. We don’t know, and probably never will know if K did seek treatment. Finding out what their HIV status is could save K’s life and the life of the person or people that K is sexually active with. But lashing out in anger instead of accepting the results and taking medication to stay healthy is throwing that second chance at life away.

In 2018, 59 new cases of HIV were identified in Palawan province (this does not include the number of new cases identified within Puerto Princesa City). There have also been 6 HIV-related deaths this year.

Dr. Genesis Samonte, an epidemiologist with the Department of Health recently presented data and said that there are no municipalities in Palawan without HIV. HIV is here. And in order to combat it and stop it’s continued spread, we must connect those with HIV to medication, and to safer sex practices so they do not infect their partners and future children. We must be more open about HIV, and more willing to discuss it. We must educate people on the four modes of transmission for HIV (sexual intercourse with an HIV+ person, mother to child transmission, breast milk of an infected person, and through contaminated blood/needles). We must talk about prevention (a major factor of which is using condoms, which no one ever wants to do or talk about!)

We must remove the stigma and discrimination that accompanies HIV and treat HIV like we would cancer or some other disease. We must show compassion and love to people living with HIV, especially when they are our family members and our friends. Until we start doing these things, it will be very difficult to turn the tide and stop HIV before it kills more Palaweños.

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