Saving HIV/AIDS victims from the stigma
http://www.hindu.com/2007/03/28/stories/2007032821300500.htm
C. Maya

Thiruvananthapuram: There is an urgent need to improve knowledge
levels of doctors and other health care providers on HIV/AIDS
infection, its modes of transmission and the universal precautions to
be adopted in hospitals to reduce the stigma and discrimination faced
by HIV-positive persons.

Gaps in information among doctors and paramedical staff about HIV
transmission and the fear of infection at workplace encourage many to
deny care to HIV-positive people. On the other hand, the stigma and
discrimination they face in hospitals discourage HIV-positive persons
from revealing their positive status.

However, an initiative by the Kerala State AIDS Control Society
(KSACS) and Engender Health India, an NGO, has proved that a rights-
based approach, which protects the rights of HIV-positive persons
while at the same time addressing the fears and concerns of health
care providers, is necessary.

The one-year project, which began in April 2006, was funded by the UK
Department for International Development (DFID). It focussed on the
health sector as a critical entry point for promoting and protecting
the rights of those living with HIV/AIDS in Kerala.

The project concentrated on increasing awareness of HIV and related
issues among health care professionals and other stakeholders through
communication and training programmes. Selected public and private
hospitals in three districts with high HIV prevalence in the State —
Thiruvananthapuram, Palakkad and Kozhikode — were chosen for project
implementation.

"The knowledge levels about HIV was extremely poor, especially among
the paramedical staff in private hospitals, who found it easier to
refer the HIV-infected to Government hospitals. The staff in
Government hospitals on the other hand were forced to provide care,
but resented it, which meant that the quality of care was poor," says
Gikson Jose, the project manager. "Often hospitals resort to
mandatory testing for HIV, without obtaining informed consent and pre-
test counselling is unheard of. Those found to be HIV-positive are
then denied care or referred to some Government facility," Mr. Jose
pointed out. In the words of an HIV-positive person, "they handed me
the dressing and asked me to do it (dressing the wound) myself."
Health care providers on the other hand pointed out that "we cannot
approach an HIV-positive person as a normal patient. We deal with
their blood and blood products." The project identified that health
workers had poor knowledge of standard precautions. Training and
information on HIV-infection and precautions was restricted mostly to
doctors, resulting in the lower-level staff often denying care to the
HIV-infected. "Our subsequent interactions with health providers
found a marked change in their attitude towards HIV-positive persons.
Also, they had implemented standard precaution processes. We are now
looking to scale up this initiative across the State," a KSACS
official said.