Report on the Global HIV/AIDS epidemic

Report on the global HIV/AIDS epidemic - June 2000

wide-ranging measures needed to bring this about are public statements by community and religious leaders urging solidarity with those affected, and legal and other
mechanisms for protecting HIV-affected individuals and survivors from discrimination, loss of inheritance and property-grabbing.
Psychological and social support can help reduce stigma and other negative consequences of being HIV-positive and in this way make people less reluctant to seek
HIV counselling and testing. In turn, the staff of counselling and testing facilities can
contribute to psychological support, for example, by assisting individuals to share
the news of their test result with their spouse or a trusted relative. Their contribution
could be even greater if voluntary counselling and testing services were more widely
accessible and more welcoming to certain categories of clients. In particular, these
services need to be better geared to attracting young people, couples and men.
Another challenge is time. In busy community health settings, where staff have too
much to do, it is important to find ethically acceptable ways of reducing the time
required for counselling.
Associations of people living with HIV are a good example of community mechanisms that provide both psychological and social support. Formed to counter the
social isolation often experienced by HIV-positive people and to allow them to
share and discuss their experiences and problems openly and safely, these mutual
support mechanisms provide peer support and help members cope with discrimination and stigma. One such group, at an antenatal clinic in South Africa, was
described by the women members as the only place where they could relax and be
themselves.
However, support groups are generally unable to meet one of the most important
challenges facing people in developing countries: lack of income. Most people with
HIV or AIDS are or become unemployed, and the stark reality is that unless they can
rely on broader support from government and society there is little a community
group can do to alleviate this impact.
Alleviating economic impact
Many support organizations have discovered the pitfalls of trying to alleviate the
economic hardship of their members. The AIDS Support Organization (TASO) of
Uganda, which runs support groups for people living with HIV, asked members of
one group how their home support could be improved. Three-fifths said they
needed capital to start an income-generating activity and close to half asked for
increased assistance of the kind already being provided, such as staple foodstuffs
and cash for school fees, uniforms and books to enable their children to go to
school.
In one scheme, selected TASO centres received funds to be given as revolving
loans for income-generating projects. While 75% of the projects were later
assessed as having been successful enough for the clients to repay their loans,

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