IRIN Web Special on World AIDS Day

Former president Kenneth Kaunda has led by example and openly taken an HIV test

Twenty years after the first case of AIDS was diagnosed, Zambians continue to live in denial, fear and confusion when it comes to acknowledging the epidemic.

"Stigma is basically the fear of helplessness," Eric Nachibanga, a member of the Network For Zambian People Living with HIV (NZP+), told IRIN. "No one likes to be helpless, so they have to find ways of hiding it."

Nachibanga believes that, if the government could harness its resources to provide a strong medical service and support structure, people would not be so frightened of having the HI virus, and would be more willing to be tested for HIV. "If there was some kind of hope, then people would be more willing to open up, if only to access these services," he said.

But attitudes among the country's decision makers hamper such an approach. During a parliamentary debate recently on the government's new AIDS Bill, MP Alex Chama argued that HIV-positive people should be isolated from the rest of society.

Although Chama later apologised for his remarks, following a public outcry, the level of the debate on the AIDS Bill suggested that few parliamentarians understood the implications of the legislation, which seeks to promote a more coordinated response to HIV and AIDS in a country where more than 20 percent of adults are believed to be HIV positive.

Attempts by former agriculture minister Guy Scott to discuss publicly the death of MP's, resulting in frequent by-elections, have been greeted by deafening silence from his fellow parliamentarians. "We all know why they died, but we are refusing to talk about AIDS," said Scott.

HIV counsellor Justina Bwalya told IRIN that many people avoid finding out their HIV-status in order to remain in a comfort zone that allows them to believe that they are allright. "Every time they talk or hear of AIDS or HIV testing, it is bringing imminent death closer to home, and they do not want that," explained Bwalya, who said she has tested HIV-negative.

"They also do not want to see people wasting away in front of them. That is like holding up a mirror and saying: 'This might be you next'. So they would rather shut it [AIDS] out and not see or talk about it."

According to Bwalya, only six percent of the Zambian population of 10.5 million people has taken an HIV test. "Imagine what the [HIV infection] figures would be if 50 percent of the population went for an HIV test! We have a lot of people living in denial."

Dr Waza Kaunda, chairperson of the Kenneth Kaunda Foundation for AIDS Orphans, agrees with Bwalya about peoples' fears. But, unlike his father, former president Kenneth Kaunda, who has twice publicly been tested in a bid to break the silence around HIV, Dr Kaunda is opposed to HIV testing because "it just brings unhappiness to people".

"What is the point of testing when you have no medicine or panacea to offer the person. Is it testing for its own sake. Where is the point? Just leave people alone. Let us all assume we are positive and teach about living positively."

In the 12 years that university student Gloria Mutale (not her real name) has been living with HIV, she has not told her family or friends about being HIV-positive because she does not want to be pitied.

"Because there is no cure, and there is nothing anyone can do, people feel sorry for you," Mutale explained. "I have seen it when they see a person with ARC [AIDS-related illnesses] or if they hear that someone has HIV. I do not want that. I would prefer to be sent to the village to die, and people would believe it was witchcraft."

Such beliefs still abound, as illustrated by the findings of recent research into stigma and discrimination conducted by the NGO Kara Counselling Trust. "Many people still do not understand that HIV is not airborne or cannot be acquired with dry contact," said programme officer Sue Clay. "People in rural areas also still believe that HIV/AIDS is caused by witchcraft."

In rural areas, stigma is linked to ignorance and poverty, Clay continued, while in urban and peri-urban areas it has more to do with the fear of infection, and having to face up to the implications of HIV and AIDS.

Traditional healer Richard Vongo said that in rural areas, sudden, prolonged or incurable illness has always been attributed to sorcery. And because people are said to die from known diseases such as tuberculosis and malaria rather than from "AIDS", it was difficult for many people to believe that HIV and AIDS exists.

People do not want be told about their sexual conduct. "There are two subjects that are a taboo: sex and death. A man does not want to be told he is dying, neither does he want to be told he should not have several wives and concubines, or that having unprotected sex with multiple partners is dangerous," Vongo added.

According to Clay, the Kara research showed that AIDS orphans can be subjected to double discrimination, firstly because their parents have died of AIDS, and secondly because the children are seen by the relatives now caring for them as unwanted mouths to feed when resources are scarce.

Meanwhile, the Kara research also found that women – in particular female sex workers - are stereotyped as carriers of the HI virus.

Bwalya believes that such stigma and discrimination was a legacy of the early days of the disease, when the media portrayed AIDS as an affliction of gay and promiscuous people. If the kind of information on HIV transmission being disseminated now was available then, there would not be such stigma, she said.

"Now no one wants the association with AIDS – to be judged a person of lesser morals, to have your heterosexuality questioned. Human beings care a lot about how they are perceived in their community, and having HIV is considered a shame, so people will not talk about it."

But not everyone is quiet. To mark World AIDS Day, Winston Zulu, who went public about being HIV-positive in 1990, has printed 1,000 t-shirts emblazoned with the slogan "I am HIV positive – do not stigmatise me". His intention is that President Levy Mwanawasa and other MP's should wear the t-shirts on 1 December.

Zulu said he has targeted politicians because there is a serious lack of political will to tackle HIV and AIDS in Zambia. "They have passed the AIDS Bill now let them pass the stigma," said Zulu. "We always assume stigma is among the ignorant or the rural poor, but we are seeing discrimination among seemingly educated, well informed people."

Zulu continued: "During my time, I was spat on, people would not sit next to me, and my family threw me out. Now it is not politically correct to discriminate against PLWAs [People Living with HIV and AIDS], so it is done more discreetly."

ZAMBIA: PlusNews Country Profile

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