Report on the Global HIV/AIDS epidemic

Report on the global HIV/AIDS epidemic - June 2000

Not surprisingly, the great majority of individuals who suspect or know they are
infected do not wish to disclose their status publicly. In the absence of support for
sharing the news, most people shrink from telling their spouse or partner that they
have HIV. Families protect their loved ones from disclosure during and even after illness and death, and those who care for them often collude in the denial. In a city in
South Africa with a high prevalence of HIV infection, one hospital runs a training programme for providers of home-based care for the dying in which the word "AIDS" is
never mentioned.
It takes no great leap of the imagination to see that, for individuals, this wall of
silence hinders both prevention and care. If people are so afraid to acknowledge or
even find out that they are infected, they will lose precious opportunities for warding
off or treating illnesses brought on by the infection (see pages 105-106). If couples
cannot talk about risks that either one may have taken, it is hard for either partner to
bring up the issue of condoms or HIV testing as a way of preventing further spread
of the virus to the spouse or child.
The stigma surrounding AIDS can extend into the next generation, placing a further
S emotional burden on the shoulders of orphans and other survivors. When children
whose parents had died of AIDS in the hard-hit rural community of Rusinga Island,
Kenya, were asked about the cause of their parent's death, the single most common
response was witchcraft or a curse. Often, they gave detailed explanations of the
nature of the curse. None mentioned AIDS.
/
This reluctance to recognize the cause of death was not the result of ignorance
about AIDS. As Figure 13 shows, knowledge about AIDS was more or less universal
among these children. Many were also prepared to recognize that AIDS had killed
many people in their community. The closer the questioning came to home, however,
the less the willingness to acknowledge the personal impact of the disease. Not one
of the 72 AIDS orphans in the study said that their parents had died of AIDS.
Uninformed and hence vulnerable
In the last decade, extraordinary strides have been made in imparting to people the
basic facts about HIV: how it is transmitted and how it can be prevented.
Remarkably high proportions of people of all ages in most continents know about
HIV and AIDS, and most can repeat the basic facts about the transmission and prevention of HIV infection.
Despite generally high levels of basic knowledge, however, millions of people around
the world are still vulnerable to HIV because they do not know the basic facts.
/Pockets of ignorance and misinformation survive even in the worst-affected populations. In the South African town of Carletonville, for example, only 40% of men or
women knew that an individual can live with the virus for many years without any

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