dr nomagugu setlhare oagile

HIV and AIDS RELATED STIGMAA CHALLENGE TO MENTAL HEALTH PRACTITIONERS.   PAPER PRESENTATIONByDr Nomagugu Setlhare-Oagile: 

HIV and AIDS RELATED STIGMA A CHALLENGE TO MENTAL HEALTH PRACTITIONERS. PAPER PRESENTATION By Dr Nomagugu Setlhare-Oagile KENYA ASSOCIATION OF PROFESSIONAL COUNSELLORS 8th Counselling Conference 4th – 6th September 2007 Nairobi, Kenya

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“Health workers are expected to know, feel and act in certain ways. But who has prepared them for this HIV/AIDS? Many health workers have the same information the man on the street has. …. The disease is fatal! Who is not afraid of death? Health workers are in it day in day out. They have not been targeted for any special education program that is relevant to their situation. Knowledge and skills yes, that they have, it is part of many training programs. But what about preparing them to come to terms with their fears and anxieties about their own sexuality and mortality, their prejudices?” Florence Mhonie, Kenya (http://www.hdnet.org/home2.htm; stigma-aids: health care provider – 17)

Stigma Defined: 

Stigma Defined According to Patterson (2001), stigma is the most powerful obstacle to prevention of HIV transmission and to the effective care for people living with HIV or AIDS. Weiss and Ramakrishna (2001) offer the following definition. Stigma is a social process or related personal experience characterized by exclusion, blame, or devaluation that results from an adverse social judgment about a person or group.

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Goffman (1963) defines stigma as an undesirable or discrediting attribute that an individual possesses, thus reducing that individual’s status in the eyes of society. Stigma can result from a particular characteristic, such as a physical deformity, or it can stem from negative attitudes toward the behavior of a group, such as homosexuals or prostitutes. Under Goffman’s definition, stigmatization is the societal labeling of an individual or group as different or deviant. Another definition is that, stigma is a powerful tool of social control; Stigma can be used to marginalize, exclude and exercise power over individuals who show certain characteristics (National AIDS Trust, 2002).

Factors which contribute to HIV/AIDS-related stigma:: 

Factors which contribute to HIV/AIDS-related stigma: Fear - HIV/AIDS is a life-threatening disease. This fear can be so strong that people do not even want to think about the possibility of being positive. This leads to denial to stop being stigmatized. They will not access services for fear of being discovered. Lack of HIV/AIDS information. Just not knowing the difference between HIV and AIDS can be problematic. Very little information or conflicting messages can bring negative responses. People are scared of contracting HIV thus distance themselves from the infected. Secrecy- no open discussions because people do not feel safe and comfortable.

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The disease’s is associated with behaviors (such as promiscuity, homosexuality, and injecting drug-use) that are already stigmatized in many societies People living with HIV/AIDS are often thought of as being responsible for becoming infected. Religious or moral beliefs lead some people to believe that having HIV/AIDS is the result of moral fault (such as promiscuity or ‘deviant sex’) that deserves to be punished. Lack of HIV/AIDS services

Csler Stories: 

Csler Stories We are expected to stand up for our clients. A counselor spoke about how difficult the advocacy role is and shared this: My client shared about how rude people at home and at work were since she started showing signs of illness. She also spoke about peoples attitudes at the hospital and how the Nurse scolded her for forgetting her treatment card. She said “it is not the nurse’s rudeness I resented, its how she did and said it. She was yelling on top of her voice saying you positive patients always want special treatment, you could see other patients rolling their eyes towards me” I was speechless.

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Disclosure is yet another dilemma that clients bring to sessions as this Counselor reported: A client said “you talk about disclosing our status to family, friends or even co-workers. I told a colleague that I suspected I was positive. She in turn told others I was positive. Now people look at me funny and even gossip, it’s all over the place. There is no respect and people can’t just keep other peoples’ secrets secret especially with HIV”

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We have a helper (maid) who has been with us for years. No one in my family had problems with her until she got sick. Again, in the eyes of family members, you are not just Counselor but a doctor as well. They expect you to read through the person who is infected and tell them what is going on. My younger brother said this about our helper (maid). “Don’t tell me you too are in denial about X? Why do you allow X to continue cooking for us? if she infects us what will you do?” The thing is, we all are suspicious, she has not disclosed to any of us but people expect answers from me

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A student intern shared: I can spot a person with HIV. What gets me stuck in therapy sometimes is that, you have this client with obvious symptoms and yet is not talking. He/she will talk about everything else but HIV symptoms. My frustration is I want to know how she is coping. She does not seem to trust me. Sometimes I want to probe but don’t know how?

Csler tips on reducing stigma: 

Csler tips on reducing stigma A colleague said: Separate the infection from the client. Find out how they are coping day to day and empower clients to say “I’m still a person, not this diseased body” or “I’m a person first, not someone with HIV.

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We need to accept our client as they are; help them accept their situation. Once the person reaches acceptance the better they are prepared to deal with people’s perceptions. Be champions for our clients – use every opportunity to educate people about the consequences of stigmatizing others Learn to deal with our own areas of discomfort, lest we communicate negative messages to our clients without realizing it.

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Another colleague said this: I think there is need to educate people on the effects of feeling rejected and stigmatized. We need to act as advocates for the infected and help people to understand that HIV/AIDS is one of those chronic diseases, which may infect any body.   

Reducing Stigma: 

Reducing Stigma Counselling Capacity Building Benchmarking