World AIDS Day - December 1 - and there was much talk and several reports on the global AIDS estimates, down from 39.5 million to 33.2 million. Many also talked about their achievements in the area of HIV/AIDS prevention and care and elucidate plans, which they actually should have pursued years earlier.
Debates on HIV estimates don't mean much. In fact, they often take away from the real issues - those that can only be shared by people infected and affected by the infection. The issue that is truly critical and demands everyone's attention is that of the stigma and discrimination associated with HIV/AIDS. Despite the efforts made to develop non-discriminatory policies and educational programmes, people living with HIV still experience discrimination - within families, health care settings, and at workplaces and educational institutions.
"The remarks made by the hospital staff made me feel ashamed... The doctor asked my spouse to administer the injection and saline fluids on his own," shared one woman living with HIV, in an International Labour Organization (ILO) study on socio-economic impact of HIV/AIDS on people living with HIV/AIDs and their families, 2003. "My husband and I were separated without our consent. The worst part is that I can't live with my children," informed another woman living with HIV from Manipur.
Though HIV does not discriminate between women and men; discrimination does. As always, women face the worst kinds of discrimination. The story of Shanti (name changed), 32, from Kerala is a heart-wrenching example. "I have been HIV positive for the last four years. I got married while I was studying. When my daughter was eight months old, my husband fell sick. He was declared HIV positive when I was carrying our second child. I was also tested positive. It took me long to overcome the trauma. My doctor refused to help me. I approached many hospitals but nobody was ready to admit me for delivery. With much difficulty one doctor agreed. My husband passed away when my second daughter was only 10 months old. My in-laws threw me out of the house. They threatened that they would kill me if ever I disclosed my status to any one," she recalls.
For people living with HIV, discrimination continues beyond death. Pratap (name changed), 32, from Maharashtra, says, "People are still so ignorant that they don't attend the last rites of a person, who has died of AIDS. I have seen cases where only five to sixpeople were present to perform the last rites."
However, it hits hardest when people face discrimination at their workplaces and lose their job or source of earning. ILO has been organizing workshops, in collaboration with the Indian Network of People Living with HIV/AIDS (INP+), (2006-07), for people living with HIV/AIDS to train them in workplace advocacy. During sessions, people have shared their personal experiences of discrimination. In fact, groups of positive people have also met up with employers and trade union and government officials for advocacy sessions.
"I was working in a garment factory and performing exceptionally well, despite that they dismissed me just because of my HIV status," reveals an HIV positive person from Uttar Pradesh (ILO training session, Delhi, July 2006). Even self- employment is difficult to sustain due to the attitude of the community. "I had a shop in my village. When people came to know of my status they stopped coming to my shop. Ultimately, I had to close it down," shared another person.
HIV/AIDS is affecting the fundamental rights at work. There is enough evidence of people not being recruited due to their HIV status, losing their jobs, being passed over for promotion and other employment benefits, and facing discrimination from co- workers. And this is largely due to the fact that employers are generally unaware about issues related to HIV/AIDS. Reveals an HR (Human Resource) manager of a Delhi-based private firm (ILO workshop, 2007), "At the time of recruitment, I will not hire a person with HIV. I will certainly not buy a problem for the company; I see recruitment as a buying-selling relationship. If I don't find the product attractive, I will not buy it."
The fact is that employers do not have the right information about HIV, and the national policy. They do not know that despite being infected, people can live a long productive life for years. The infection does not spread by day-to-day casual contact like shaking hands, eating together, sharing toilets, or working at the same machines. And now there is treatment available to prolong the life of people living with HIV. So, investment in training of such people does not go waste. They can remain with the organization for long and contribute to its goals. Therefore, there is simply no rationale for not hiring people living with HIV, or for not keeping them in employment. The ILO Code of Practice on HIV/AIDS, endorsed by the National AIDS Control Organization (NACO), employers' organizations/chambers and trade unions, provides clear guidelines for development of HIV/AIDS policy and programmes at workplaces.
The best way to convince employers to develop non-discriminatory policies is to bring to the fore workers living with the infection. Says Prakash, from the Madhya Pradesh Network of People Living with HIV/AIDS, (Associated Chambers of Commerce and Industry of India, Delhi, July 2006), "I am working with an insurance company. When detected HIV+, I thought it was the end of my life. Initially, I faced discrimination but I proved myself. I am working as hard as anybody else to prove that even with an HIV status one can work." Naveen of the Delhi Network of Positive People appeals, in an ILO poster and film for enterprises, "Work is more than medicine to us. It enables us to bring home food and medicine. If you take away our jobs, you will kill us faster than HIV."
Pawan from the UP Network of People Living with HIV, has some advice for employers on how to combat HIV stigma in a workplace, "The earlier you provide HIV education the better it would be for your employees. You wouldn't like them to get infected." (ASSOCHAM, Delhi, July 2006)
HIV infection is preventable and prevention will work in India. However, the response cannot be led solely by the Ministry of Health and Family Welfare. It has to be a multi-sectoral effort since HIV impacts everyone. And, the global lesson is that stigma and discrimination have to be fought if prevention programmes are to succeed. So, if one has to commit to the AIDS day message of Stop AIDS - Keep the Promise, one has to commit to end stigma and discriminationrelated with HIV/AIDS.
(The author is Technical Specialist (HIV/AIDS), South Asia, International Labour Organization, ILO Subregional Offfice, New Delhi. The views expressed are his own. Some names of people living with HIV have been changed to protect identity.)