Let’s talk about stigma – you know, that nasty human tendency to shame groups of people as outcasts because it makes you feel better than “them” and somehow protected from “them”.
Stigma remains a defining feature of how we have faced HIV and treated people who live with it. It’s still an obstacle against beating the HIV pandemic. It’s also kept activities like sex work and injecting drug use underground, where they can so easily be lethal. They often are.
And it’s insisting on poking out its hideous, screeching head as we are engulfed in the human nightmare of the novel coronavirus pandemic.
We’re seeing it already
Just last week (which seems like a lifetime ago), I was told, gleefully, that a hotel had “locked someone up” because he was suspected to be “infected” with the virus that causes COVID-19. It turned out to be fake news, but the point was made. Stigma, by the way, thrives on fake news and misinformation.
On a WhatsApp group, a participant suggested that we “go out and shoot” someone who had tested positive for the coronavirus because “she knowingly went to a high-risk country and brought it back here”.
Someone I love has the coronavirus. She has been very ill, and, thankfully, is recovering in self-isolation at home, with her temperature back to normal for the first time in 10 days.
“Before I contracted the virus,” she told me, “I would have said there wasn’t an issue as I would never have thought of blaming someone for being sick. But I know that my own gut response to this has been to keep it quiet and only mention it to those closest to me.”
Then I listened to an SABC News interview with a woman who has the virus. She disclosed her status to her neighbours in a small complex to explain why she would not be attending a meeting. By doing so, she said, she opened herself to “hateful and shameful acts” by “people that you are supposed to trust”.
“I was attacked twice: 1) by the disease itself; and 2) by my neighbours,” she recounted. Hospital staff had told her to self-isolate at home, but her neighbours called the police because they felt unsafe with her being in isolation in her own home. The police “were knocking on my door”, demanding entry, and threatening to produce a warrant of arrest.
A police colonel eventually intervened. But “by then, I was highly traumatised … it reminded me of the police raids that used to happen during apartheid.” She did get an apology from the police, but her neighbours have “increased their harassment”.
If people test positive, “they need time to recoup; they need peace and understanding; they need compassion, not shameful and hateful reactions.
“Things like this must stop,” she said. “Imagine now how many people are going to be fearful of disclosing, fearful of attacks.”
In the dark
And that’s the trouble with stigma.
It stops people from getting tested and disclosing whether they have the virus. Stigma keeps things in the dark where they cannot be dealt with. By stigmatising people, you are fuelling the spread of the virus. That is the responsibility you must be prepared to bear.
Stigma also creates the space for the very worst of human behaviour. It emerged recently that South African state hospitals had sterilised at least 48 pregnant women living with HIV without their consent.
Stigma kills directly, too. In just one example, a Namibian man strangled his girlfriend to death after she disclosed that she had tested positive for HIV.
A tale of two viruses
Indeed, we need only look at the journey of HIV to work out where the stigma around the coronavirus is going fast.
The former Executive Director of the Joint United Nations Programme on HIV/AIDS (UNAIDS), Michel Sidibé, put it succinctly:
“Whenever AIDS has won, stigma, shame, distrust, discrimination and apathy was on its side. Every time AIDS has been defeated, it has been because of trust, openness, dialogue between individuals and communities, family support, human solidarity, and the human perseverance to find new paths and solutions.”
The Geneva-based International AIDS Society titled its Annual Letter 2019 Getting to the heart of stigma. “The early days of the HIV epidemic gave rise to two epidemics: one that was viral in nature and another composed of fear, loathing and blame,” it said. “Three decades into the epidemic, it remains clear: HIV AND AIDS DOESN’T DISCRIMINATE; PEOPLE DO.
“Since AIDS first appeared, we’ve made considerable progress in reducing new HIV infections and AIDS-related deaths. But our lack of progress in combatting the epidemic of stigma, discrimination and social exclusion undermines our efforts addressing the diagnosis of HIV, and treatment and care of people living with the virus. The persistence of stigma in the context of HIV also causes immense human hardship and diminishes us as a global community.”
In reality, it’s not that easy to acquire HIV. The virus transmits through sharing bodily fluids, such as through sex or sharing needles. And it dies almost immediately outside the body.
Not so with the coronavirus. It lives for who knows how long outside the body. It passes through touching and breathing. It’s massively contagious.
The hard truth is this: up to 70% of us are going to get the coronavirus. Some of us will be very ill with COVID-19. And some of us will die. In other words, it is coming for you and your family. What will you do then? Who will you point a finger at then?
Be kind now.