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Zero Discrimination Day: an Answer to HIV-related Stigma and Discrimination

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As part of the Zero Discrimination Day organized on March 1, Fedactio is looking into the issue of discrimination against HIV-positive people. While there has been remarkable medical progress in the fight against HIV, the social reality is quite different.

This year, the United Nations decided to tackle discriminatory laws which deprive people of some essential services or restrict the way they live on the simple basis of their identity. Since last year, in terms of global progress, it is now possible in the Philippines for 15-year-old adolescents to be tested without parental consent and in Malawi, measures that criminalized non-disclosure of HIV status have been repealed.

Limited or even denied access to health care, discrimination in recruitment, discriminatory treatment in the domestic sphere, refusal of a possible promotion at work... all discriminatory situations experienced by most of HIV-positive people on a daily basis in our country too. According to a study published in 2014 (Vespa2 study conducted in France on a sample of 3,000 HIV-positive people), 26% of people living with HIV report having already experienced discriminatory treatments in various contexts, including recruitment (24%), family environment (11%) and access to health care (8%). In this last area, a testing was carried out in 2015 by the association for the fight against AIDS "Aides" to check what attitude health professionals adopted towards HIV-positive people. The test was conducted by telephone and each person called twice, once without mentioning they were HIV-positive and a second time specifying it. The result: 1 dentist out of 3 refuses to take care of a patient because of his HIV status. In gynaecology, if situation is less alarming, people are still discriminated with 7 out of 116 gynaecologists refusing an appointment to an HIV-positive person.

In Belgium, the situation is similar, with 13% of HIV-positive people reporting that they have already been denied access to health care because of the virus, or 15% reporting that they have already faced a refusal or complication in accessing services such as insurance or bank loans. To these discriminations come to be added others such as those related to ethnic origin, skin colour, sexual orientation, socio-economic status or gender. Thus, by considering HIV status as a common and main ground of discrimination, studies on the subject have shown that HIV-positive women are more discriminated against than HIV-positive men or that HIV-positive homosexual men are more stigmatized than heterosexual men living with the virus. Therefore, the combination of one or more of these different factors, coupled with serophobia, leads to different forms and degrees of discrimination.

While society's perception of HIV and people living with it has changed very little since the early 1980s, the disease itself has evolved and the care and treatment of patients have made huge progress. Today, antiretroviral treatments make it possible to make the viral load of HIV-positive people undetectable, which means the level of virus in their blood is brought to such low levels that blood tests cannot detect it anymore. Knowing that the higher the level of virus in the blood, the greater the risk of transmission of the virus, an undetectable viral load means there is no risk of passing on HIV. Although this type of treatment is a major step forward in the fight against HIV, the general public still knows little about it and there are still many misconceptions and misinformation about the virus and the way it can be transmitted from one person to another. Elise Marsicano, socio-demographer, member of the scientific committee of Sidaction and author of the Vespa2 study who conducted a post-doctoral study on discrimination against HIV-positive people, states that awareness and education about the virus are key elements in society's perception of people living with it. Indeed, informing people that, contrary to the numerous myths around how HIV is passed from one person to another, it is not transmitted through insect bites, saliva, sweat or even a simple kiss would allow society's actors to have a better understanding of the virus and people living with it. Mrs Marsicano also adds that the first form of discrimination against HIV-positive people consisting in making them invisible, the first step towards eliminating all forms of discrimination against them would be to give them the visibility and recognition inherent to every human being.

The medical advances in the fight against HIV are remarkable, but it must be noted that they are still largely unknown. Stereotypes remain entrenched in our society and education remains the best weapon to eradicate all forms of discrimination against people living with HIV. As a Federation of associations convinced that the abolition of discrimination will require the education of civil society, Fedactio wanted to highlight this issue and the admirable work done by the numerous field associations in order to improve the everyday life of people living with HIV. It takes time, but it's worth it.
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