At a recent workshop, Dr Rovin Deodat, communication consultant with PANCAP, explained that stigma refers to negative attitudes towards people with HIV/AIDS, while discrimination refers to negative behaviour towards these people. He pointed out that fear of stigma and discrimination influences every aspect of HIV prevention and control, with the result that:-

• People are afraid to come forward to be tested for HIV
• People are afraid to admit that they are HIV positive (fear of stigma makes them hide it).
• Fear prevents people from coming forward to seek treatment if they are HIV positive.
• Fear of being “found out” prevents people from using condoms or taking other protective action. (“Why the sudden change?”)
• Hiding one’s HIV status from families and friends prevents partners, families and communities from providing the education, care and support that HIV positive people need.
• It therefore forces the epidemic underground, and leads to a situation where many HIV positive people are “hidden from view”.

Cathy Buffonge has lived in Montserrat for nearly 40 years, many of which were spent in the health field. She has written extensively on the volcanic experience in Montserrat, as well as on social, cultural and other Montserrat events, and on Caribbean health issues.

Dr Deodat said that the known HIV cases could be just the “tip of the iceberg”, with many HIV positive people in the community unknown to families and health care workers through fear of stigma and discrimination. It’s therefore urgent to tackle this problem.

In conducting a series of workshops around the Caribbean, PANCAP is hoping to build a communication strategy to combat this problem. In each country visited, workshop participants work on national communication strategies aimed at reducing the scourge of stigma and discrimination, and developing more positive and accepting attitudes towards people with HIV/AIDS. PANCAP will look for common threads running through these national strategies and use them to develop a Caribbean strategy.

Dr Deodat explains that discrimination takes many forms, and can be found in employment, education, health care, immigration, the justice system and in basic human rights, among others. Of course it can also be found among parents, school children and the general public. This is so even if these people haven’t knowingly met anyone who is HIV positive. The negative attitude and belief is there.

It seems that although many people know the basic facts about HIV/AIDS, and how it can and cannot be caught, they are not ready to put this into practice. For example they might know that you can’t catch HIV from holding someone’s hand or sitting next to them, but in practice an irrational fear takes over and they may avoid the person. These are attitudes that the PANCAP project hopes to change.

PANCAP, which was established by CARICOM in 2001, is an association of many partners. These include all the Caribbean countries (including Cuba, Haiti and the French and Dutch islands), some non-Caribbean countries like Canada and France, international funding agencies, regional agencies such as PAHO and CAREC, and non-governmental organizations (NGOs) such as the Red Cross. The aim is for all these agencies to work together in partnership to combat HIV and AIDS. Reducing stigma and discrimination is an important part of this.