Using the Law to address HIV and AIDS related Stigma and Discrimination - SAfAIDS Discussion Forum

On Friday 30 March 2007, SAfAIDS held a discussion forum entitled, "Using the law to address HIV and AIDS-related stigma and discrimination". The discussion, which is also going to be held in three other southern African countries as part of a SAfAIDS documentation process, was convened to address the root causes of stigma and discrimination and highlight laws and policies that exist in Zimbabwe that can be used to address these twin problems.

Presented by Mrs Emilia Muchawa,

Director: Zimbabwe Women Lawyers Association and Key Discussants to respond to critical issues raised and Featuring Patsimeredu Edutainment Trust

Discussion Forum Review

On Friday 30 March 2007, SAfAIDS held a discussion forum entitled, "Using the law to address HIV and AIDS-related stigma and discrimination". The discussion, which is also going to be held in three other southern African countries as part of a SAfAIDS documentation process, was convened to address the root causes of stigma and discrimination and highlight laws and policies that exist in Zimbabwe that can be used to address these twin problems.

The lively debate was preceded by a drama presentation by the Patsimeredu Edutainment Trust. While dealing humorously and incisively with the main themes of the discussion - namely stigma and discrimination in common social settings - the play also addressed the cultural practice of wife inheritance. This tradition is not only fuelling the HIV epidemic, but also runs counter to current legal reforms that are moving away from such retrogressive customs.

The audience - made up mostly of people living with HIV (PLHIV), HIV and human rights advocates, activists and civil organisations - responded to the play which proved to be an important reference tool throughout the discussion forum. Speakers and participants constantly referred to the scenarios that they had seen being acted out as the drama focused on how a working man is let off from his workplace ......(PLEASE HELP HERE).Participants, for instance, made reference to the self-stigma that Jasper, the chief actor, put himself through after he had found out that he was HIV positive.

This highlighted the importance of theatre as a means of participatory communication, and therefore development, as it provided the audience with practical thematic anecdotes that formed useful examples throughout the discussion forum.

As Mrs. Chingandu, the SAfAIDS Executive Director and facilitator of the discussion noted, "The purpose of this discussion is not to focus on how stigma and discrimination are happening, but how to address them differently from a human rights' perspective."

To steer the discussion, Mrs. Emilia Muchawa of the Zimbabwe Women Lawyers Association (ZWLA) delivered the key paper discussing in detail the laws and policies that exist in Zimbabwe that can be used to address stigma and discrimination. She began, however, by making the distinction in definition between stigma and discrimination. As she explained, HIV-related stigma is a mental form of prejudice and refers to all unfavourable attitudes, beliefs, and policies directed towards people living with the virus, as well as those in close association with them (family, friends, work colleagues). These feelings of shame, blame, fear and rejection can also be inflected inwards with the person living with HIV practising what is known as self-stigma. Discrimination, on the other hand was defined as the actions that results from the attitudes related to stigma. These often include restriction and exclusion from wide-ranging activities.

Aspects of gender stereotyping were also discussed with Mrs. Muchawa noting that women are often seen as being subordinate to men socially, psychologically and economically. This, she noted, helped shape the way HIV infected women and girls are perceived by society as they attract more contempt and rejection than men do. She also added that stigma-induced actions such as not going for testing for fear of ostracism and the ripple effects of disclosure of one's status as areas where the law could come in to ensure people's human rights are upheld.

After this look into stigma and discrimination, Mrs. Muchawa took a look at the different international human rights instruments in order to assess whether they were facilitating the fight, or acting as catalysts of S and D. These laws and policies included international covenants and charters such as the Universal Declaration of Human Rights and the United Nations General Assembly Special Summit (UNGASS) Declaration of Commitment on HIV and AIDS. Closer to home, Muchawa looked at such instruments as Zimbabwe's constitution, HIV/AIDS Policy of Zimbabwe and other laws dealing with labour relations, sexual offences, domestic violence and inheritance.

Muchawa cited clause 6.2 of Zimbabwe's HIV and AIDS Policy, which recognises the risk of stigma and discrimination against people living with HIV, and recommends that all asymptomatic people with HIV should be treated as any other healthy individual with respect to social amenities and citizenship rights. One participant noted that the clause did not make reference to how to treat those HIV positive people who are symptomatic. This was noted as a clear oversight within the policy.

An important issue not often taken into consideration was that of stigma and discrimination against commercial sex workers. Clause 6.7 of the same Policy, as well as the Miscellaneous Offences Act criminalise loitering for the purposes of prostitution - something Mrs. Muchawa noted was stigmatising. "This is criminalisng the supply side of commercial sex work and not the demand side," she stated, highlighting the gender and social disparities that help in perpetuating cycles of stigma and discrimination. She also mentioned how inheritance laws, due to the complexity of procedures and processes and inaccessibility of courts, meant that women were not always able to claim or defend their rights. Major challenges involved in using the law identified included the negative attitudes and biases of court officials, ignorance of the law, and economic dependence upon perpetrators.

After giving the list of challenges involved in using the law, the discussion was opened to other members of the panel of discussants. Mrs. Olga Madondo of CONNECT noted, "Stigma and discrimination are affecting the treatment plan, and they hurt more than the disease itself." She gave the practical example of how caregivers of HIV positive patients are accused of discrimination when they use gloves and posed the question to the audience

"Do we have laws that protect the other side?"

While this was a discussion forum to discuss stigma and discrimination experienced by those infected and affected by HIV, the issue of actions that may be misconstrued as being prejudicial to PLHIV was also discussed. Are the people who try to protect themselves from the perceived harm, both physical and economic, always perpetuating stigmatising and discriminatory attitudes and behaviours? From a business point of view, the this debate was looked at from the perspective that production is the key concern for employers, and that this was at times in direct conflict with meeting the rights of PLHIV.

Some participants noted that the human resources departments of organisations look at absenteeism and retrenchment on the basis of how they affect productive income. "I will move you if you are not moving my business," a representative of the human resources department of one of Zimbabwe's prominent banks declared. The current Labour Relations Regulations provide PLHIV the same sick leave conditions as those for any other condition. This means that an employee is entitled to 90 days fully paid sick leave, and thereafter another 90 days leave on half-pay. Some participants argued that an extension of this leave period could become a liability for a company, especially in light of the current economic crisis in Zimbabwe. "Companies in Zimbabwe are currently downsizing and HIV is one of the key criteria that companies are using when retrenching," observed one member of the discussion.

Another participant noted the financial losses incurred by companies in taking out life assurance for their employees; particularly those who are HIV positive whom he said "would die within a few months."

However, some participants argued that any activities to the exclusion of PLHIV were stigmatising, and that the stigma was continued by "throwing someone out of work" when he or she was absent from the workplace for longer than the legally allotted 180 days. One speaker added that such loss of financial standing was what disempowered the HIV positive person who could then no longer afford to efficiently take care of his or treatment and nutrition needs.

But the human resources respondents said that in fact, the problem might actually have begun with the PLHIV practising self-stigma and not initially disclosing his status to management personnel. "This person does not ask for the ARV drugs and is then absent for over 180 days. So am I dismissing them because of their positive status, or because of the lengthy leave?"

HIV in the workplace steered a large part of the debate, but other pertinent issues were raised within the discussion. Tapiwanashe Kujinga of ZAHA noted that there was need for a regional approach to the issue of stigma and discrimination through collaborative ventures among networks of PLHIV and HIV advocacy groups.

One contributor to the discussion said that one of the areas that posed a problem to Zimbabwe's efforts to counter stigma and discrimination was actually a lack of documented cases of stigma. A need for people to share experiences in order to effectively lobby against stigma was therefore identified as an area that Zimbabweans could improve upon.

The South African example was used to highlight the marked difference in how Zimbabweans are tackling the issue of stigma and discrimination. Participants cited treatment movements such as the Treatment Action Campaign (TAC), which advocate universal access to treatment for all South Africans, as well as the freedom with which campaigners disclosed their status, wearing T-shirts that confirmed their being HIV positive - something many participants noted would be a stigmatising activity for many Zimbabweans.

Those who said that they had tried to involve themselves in such anti-stigma and discrimination campaigns said they felt they were just being used. One contributor cited the National AIDS Levy advocacy campaigns in which many PLHIVs partook. "We lobbied for the AIDS levy, yet we are dying like dogs." Linked to this was the issue of meaningful involvement of people living with HIV and AIDS in policy formulation efforts.

But the audience further stratified the group of PLHIVs to discuss the rights and needs of HIV positive people living with a disability. Participants noted that it was discouraging and disheartening to observe that the treatment and care needs of this group of people were not often discussed. Contributors said that this was an area that the legislation, particularly workplace-policy related regulations, needed to look into.

To end the discussion forum, the floor was asked to come up with some key recommendations that would be used to overcome the challenges addressed. It was agreed that was needed was:

• To come up with a comprehensive roadmap on navigating the legal processes - SAfAIDS took up the task to involve itself in developing informative materials to educate people on the benefits of knowing one's status

• PLHIV must receive protection from the law, particularly through the National AIDS levy

• To give legal and health practitioners the authority to disclose one's status to their spouse or partner if they refuse to do so themselves

• To give law enforcement agents training so that they themselves do not perpetuate the cycle of stigma and discrimination against PLHIVs

• To take advantage of existing AIDS support groups, nationally and regionally, to build PLHIV's capacity and use collective experiences to lobby for laws that deal with stigma and discrimination issues

• To penetrate the rural areas with information on HIV and use of the law

For more info: cecilia@safaids.org.zw or titus@safaids.org.zw