Regions

Features

SIERRA LEONE: Efforts to break down HIV/AIDS stigma starting to pay off

[This report does not necessarily reflect the views of the United Nations]

FREETOWN, 9 December (PLUSNEWS) - HIV/AIDS campaigners in war-scarred Sierra Leone say the stigma surrounding the disease is starting to be chipped away, with more people coming forward and some not afraid to wear T-shirts announcing they have the virus.

Mariama Diarra, who works for the United Nations Population Fund (UNFPA) in the capital, Freetown, recalled the launch earlier this month of a film about HIV/AIDS called "Live and Let Live" where one member of the audience turned up sporting a T-shirt with "HIV-positive" emblazoned across the front.

"No-one would have worn such a T-shirt before," she told PlusNews.

The man who became the first Sierra Leonean to publicly announce he had the HI virus agreed times had changed since he made his declaration eight years ago.

Samuel Williams had his house ransacked, his personal possessions set alight and was forced to seek refuge with his HIV-positive wife and live in a hospital cubicle after he admitted he had the disease.

"For people living with the virus it is not the death that we are afraid of, it is what people are saying about us, how we contracted the disease, that is what we are worried about," Williams explained in a recent interview.

He said the hate attacks left his wife badly shaken and made her give up hope, leading to her death just a year later.

But Williams, who was diagnosed nine years ago, believes that now more help is at hand and the taboos are being weakened, people are becoming less reluctant to keep quiet about being HIV positive.

Sierra Leone's healthcare system virtually collapsed during the decade-long civil war that devastated the West African country between 1991 and 2002 but slowly the infrastructure is being rebuilt with donor money.

Williams, who heads an organisation called People Living with AIDS and HIV, says there was a time when he knew of just 40 people with the disease.

"Now over 200 people have come out and more are coming out," the 45-year-old said. "There is life after HIV. We are ready for the crusade and to influence the virus by positive living."

The head of Sierra Leone's National AIDS Programme, Brima Kargbo, paints a similar picture.

"People are coming forward," he said, pointing to the success of radio, television and press campaigns to raise awareness. "There is still stigmatisation but it is not as important as it was."

As in many countries emerging from conflict, an accurate prevalence rate is hard to come by. Government officials estimate there are 45,000 people living with the virus in Sierra Leone and the prevalence rate is around one percent.

That is well below the average five percent across the West African region but the study, conducted jointly by Sierra Leone and US health officials just after peace was formally declared in 2002, did not include some still-tense former conflict zones.

The Global Fund to Fight AIDS, Tuberculosis and Malaria cites what it calls "more reliable figures" based on a survey earlier this year of pregnant women which puts the national prevalence rate at 3.4 percent, rising to almost five percent in Freetown.

And the World Bank also believes the epidemic has made greater inroads into the diamond-rich country.

"Whatever the actual rate, it is widely accepted that the rate is on the increase, and that the critical threshold of five percent is either passed or near at hand," it said.

After nearly three years of peace and with the UN peacekeeping mission (UNAMSIL) having handed responsibility for security back to local authorities, aid workers can begin to collect the data for an updated and accurate snapshot of HIV/AIDS in Sierra Leone. UNAIDS is planning a survey early next year.

According to the Global Fund, the massive displacement of people within Sierra Leone during the civil war, may well have created conditions for the disease to spread.

The sexual slavery and widespread rape which thousands of Sierra Leonean woman suffered at the hands of both government militiamen and rebels is another factor which may have caused the prevalence rate to rise, as well as the deployment of foreign troops from countries with significantly higher prevalence rates, the Global Fund said.

Commercial sex workers, military and ex-combatants as those among the most at risk, the Fund found.

But there is a note of optimism in the Global Fund's report, accompanying an April 2004 funding request for almost US $18 million to be spread over five years.

"The epidemic is most probably at the stage where comprehensive prevention efforts among vulnerable groups, supported by sensitisation, awareness-raising and prevention efforts in the general population, and the provision of care, support and treatment for people living with HIV/AIDS, could prevent the scale of epidemic experienced in other post-conflict situations," it said.

Diarra of UNFPA admitted that while progress has been made in knocking down taboos, work remains to be done.

"Some people are still scared. They think HIV/AIDS is still a death warrant, or they think people have had a bad sexual life and should be quarantined like lepers," she told PlusNews.

"But if you give people the proper information, if you tell them there's a life after HIV, if you say live and let live, you cut back discrimination and get to more people that have it."

[ENDS]