Addressing Stigma and Discrimination in North Eastern Province
Amina* was married off by her father in 2002 to a man she only lived with for two years. Her husband died in 2004 from a disease she later discovered was tuberculosis; a fact that her in-laws kept a secret. Following the death of her husband, Amina fell sick many times and was advised to go for voluntary counseling and testing. She discovered she was HIV positive. This began one of the hardest times of her life. She was shunned by her in-laws and chased from her husband's home.
Amina's experience is not unique; many people in Kenya who are infected with HIV have experienced stigma and discrimination including prejudice, negative attitudes, abuse, and maltreatment. In the 2009 Kenya Demographic Health Survey, only 32.6 percent of respondents who had heard of AIDS expressed accepting attitudes about caring for a sick family member, interacting with an HIV-positive market vendor, or being comfortable with their children having a teacher with the AIDS virus.
In North Eastern Province (NEP) Kenya, a region where cultural practices are often intertwined with religious beliefs, experiencing such stigma and discrimination is particularly challenging. "In the past years, the issue of HIV in our community has been very negative," says Bashir Hussein Ahmed the District Medical Officer of Health, Garissa district (provincial headquarters for NEP). According to him, most people in NEP consider someone with HIV to be bewitched, cursed or promiscuous.
In an attempt to curb stigma and discrimination in NEP, the USAID-funded AIDS Population and Health Integrated Assistance II (APHIA II) project developed the Twaweza Behavioral Communication Strategy. The strategy was developed after an assessment in Garissa of people considered at high risk of HIV infection. A third of those interviewed revealed that they could discriminate against an infected person. There was also low and inaccurate knowledge of HIV transmission.
APHIA II NEP has worked to address stigma through incorporation of the subject in all trainings for community and health workers. "There is need to train and educate opinion leaders such as Imams, teachers and even the community about stigma and discrimination," says Amina, supporting the concept.
To assist with this training, videos were produced with the help of the National Organization for Peer Education. They have been part of existing trainings with community groups, such as peer educators or community health workers.
Some of the achievements of the new communication strategy include the establishment of Post-Test Clubs in all districts of NEP for people who have tested HIV positive. Support groups for people with HIV also become involved in passing on anti-stigma messages to Community Health Workers and peer educators. In addition, the project engaged local media to educate the public through local FM channels and religious leaders now speak openly against stigma and discrimination in the mosques and other forums. All these have been carried out under the pillar of the slogan; "Twaweza kuwapenda wanaoishi na virusi vya ukimwi" ("We can love those living with HIV").
*The individual's name has been changed to protect her identity.