YEMEN: "It's tough living with HIV"

By, IRIN PlusNews, July 26, 2007

For Alawi Bahumaid, 41, who recently lost his job with a Norwegian oil company in Yemen, the bitter struggle of rebuilding his life and looking for a new job starts again. "This is the second time I have lost my job because of my HIV status," he said in the capital, Sanaa. "I had such hopes this time around."

Those hopes were dashed, however, when two months after Bahumaid started the job, his previous employer was contacted for a reference, and his current employer discovered that their newest staff member was HIV positive. Fearing a revolt by the other workers if he was returned to the production line, his employer summarily dismissed him.

"It's tough living with HIV," said Bahumaid, who has done so since the 1990s. "People in Yemen don't know what HIV is, and are afraid to shake my hand or even talk to me."

He described discrimination against those living with HIV in Yemen as "rampant", and has become a reluctant advocate of sorts. "This time I'm going to speak out," he said.

But in Yemen, a staunchly conservative tribal society of some 20 million people, where over 40 percent of the population live below the poverty line, it is going to take more than speaking out to change things: it will need action, particularly by the government.

Rampant stigma

The government's National Strategic Framework for the Control and Prevention of HIV/AIDS acknowledges that Yemenis living with HIV are heavily stigmatised: they often flee or are even expelled from hospitals where they have sought treatment, and face harassment by the police.

Like other countries in the region, Yemen requires HIV sero-negative status for foreigners seeking residence or employment. HIV-infected foreigners are deported, with many policymakers considering this a necessary and fully justifiable measure, which reinforces the longstanding denial and stigma regarding HIV and AIDS.

Although the government's commitment to controlling and preventing the pandemic is evident in its adoption of a national framework in 2002, it is clear that much more is needed in terms of treatment and assistance to people like Bahumaid, who have to live with the discrimination.

"People living with HIV suffer a lot," said Fouzia Abdullah Saeed Ghramah, director of the National AIDS Programme (NAP) run by the Ministry of Health. "[They] are denied their rights, particularly in the area of employment, which in turn leads to additional social and economic problems. We're working to address that."

But efforts to combat the prevailing stigma and discrimination are up against the negative perceptions held by even the country's most educated inhabitants.

The results of a survey published in the daily Yemen Observer newspaper on 10 July indicate that shame and fear of judgment are among the greatest obstacles preventing HIV-positive people from obtaining diagnosis and treatment.

The study, conducted by researchers at Sanaa University, compared the attitudes of medical students with non-medical students, and revealed that even educated people harbour a negative bias towards AIDS patients, and often misunderstand the disease.

Low prevalence

According to the NAP, 2,075 cases of HIV have been recorded since the first case was reported in 1987. However, health experts believe the real number to be over 20,000.

"Nobody can prove it; nobody can deny it," said Abdullah Abdulkarim al-Arashi, executive manager of Yemen's AIDS Project Unit, part of the government's National Population Council, which aims to improve awareness levels.

"People prefer to view it as a western problem and are afraid to even talk about it. And without awareness they will never talk about it, nor will people that are infected go to hospitals," he said.

Although life-prolonging antiretroviral drugs are available in Sanaa and the southern port city of Aden, the country's two largest population centres, al-Arashi noted that the lack of openness about HIV prevented many people from seeking treatment.

"Our society here in Yemen is so closed. To talk about HIV is shameful, as people associate it with sex," he said. Most people believe sexual contact is the only mode of transmission.

"People are afraid to disclose their HIV status; they are afraid of the government; they are afraid of the policemen, and even of their families."

One man in Aden was barred from entering his home by his wife and children after disclosing his HIV status. "You are infected with HIV. Get out," his wife reportedly screamed before calling the police.

"Regrettably, this is our mentality toward HIV," al-Arashi said. "This is what we are trying to change now."

Lack of legislation

Although there is no legislation to protect Bahumaid and others from discrimination, the establishment of Yemen's Ministry of Human Rights in 2003 offers some hope.

Referring to the lack of legislation for protecting people living with HIV and other chronic diseases, Nusaibah Ghushaim, the ministry's manager of information, told IRIN/PlusNews, "This is something that needs to change."

She was confident that appropriate laws would eventually be passed, but feared that implementing them in Yemen could take much longer.

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AIDS women fight fear and stigma as well as disease

By, Jane Lee, Reuters, July 23, 2007

When Papua New Guinea's Maura Elaripe was diagnosed with HIV she thought it was a death sentence, but 10 years later she is still fighting the disease and the fear and stigma associated with it in her homeland.

The 31-year-old former nurse said many afflicted with the disease are left untreated to die in Papua New Guinea, a developing nation where black magic still rules many people's lives.

"I saw people dying in front of me -- deaths which could have been prevented," Elaripe told Reuters at the International AIDS Society conference on Monday.

"I saw a 16-year-old die just next to my bed. They said we don't want to waste our medicine on her. Another woman with HIV died and was put in a black garbage bag and they disposed of the body...that freaked me out. I was so scared," she said.

HIV-AIDS has found fertile ground in Papua New Guinea, a jungle-clad, mountainous nation, where polygamy is common and rape and sexual violence widespread.

Officially there are only about 12,000 people infected, but AIDS workers estimate that under-reporting and reluctance to be tested mean the real number ranges from 80,000 to 120,000.

The island's 5.4 million people, most of whom live a rural subsistence life, presently face an epidemic on a par with Cambodia, Myanmar and Thailand. An estimated 300,000 people are expected to die due to HIV-AIDS by 2025.

Papua New Guinea Health Minister Peter Barter told reporters at the world's largest AIDS conference that polygamy was a major obstacle in the fight against HIV-AIDS in his country.

"In many parts of Papua New Guinea a person can have up to 5 or 6 wives and 20 children. We have to change that behaviour, its a cultural matter and it will take some time to do it," he said.

WOMEN CARRY HEAVY BURDEN

The United Nations says close to 40 million people are infected with the HIV-AIDS virus -- almost half are women.

Women are eight times more likely than men to contract HIV during unprotected sex, with most learning they are infected once they are pregnant. Of more than 600,000 new infections in children each year, 90 percent are mother-to-child transmissions.

"In some developing countries, HIV has significantly increased the burden of care for many women, particularly in the developing world with far-reaching social, health and economic consequences," said Francoise Barre-Sinoussi, from France's Institut Pasteur, told the conference.

When Elaripe was diagnosed while pregnant, there was no counselling available -- she lived with HIV for three years without treatment.

"Nobody took care of my emotional needs or my psychological needs. I went home and I said I'll wait for the day I die," she said. "I was so scared to go out. I lived in fear."

Elaripe said ignorance of the disease saw her sick baby turned away from hospital because her mother had HIV.

"The next day she died without any medical attention because they said that I was HIV positive...and because I was positive the baby was also positive," she said.

Medical authorities also forced Elaripe to be sterilised after her diagnosis. "I felt that my reproductive rights were also abused," she said.

Despite some improvements in treating HIV-AIDS in Papua New Guinea in the past 10 years, Elaripe said the challenge of living with the disease in her homeland does not get easier with time.

"I'm hoping there will be a cure soon. I'm tired of having to get up every day to take pills...it gets scary," she said.


Source: http://www.alertnet.org/thenews/newsdesk/SYD299830.htm