One reason that HIV/AIDS is difficult to address is the strong association
that exists in the minds of both the public and policymakers between the
disease and risk groups.
Those of us wanting to deal with the infection in a more open manner
recognize that HIV must become "normalized" in the eyes of society if discrimination
and ostracism are to be reduced. When this starts to occur, testing becomes
easier to accept, so that the disease can be brought out into the open
where help can be offered. By "normalization," I mean removing the stigma
that many hold towards HIV infected people, stressing that theirs is a
viral disease with chronic consequences, not unlike hypertension, diabetes,
or various cancers. Those holding this view recognize that people with
the disease are not to be feared, since transmission occurs only through
intimate contact, easily prevented once HIV status is known. Such normalization
efforts are made easier when HIV infected people speak out, letting others
in the society see that they live and work as fellow humans rather than
monsters. An example of this kind of normalization program is the Wednesday
Friends Club in Thailand, organized for many years by the Thai Red Cross.
Of course changing the public's perception is difficult, but it can be
done if HIV is viewed more widely as a viral disease, rather than touted
as a sin.
Others argue that normalization of HIV/AIDS will not occur unless society
normalizes the view of the now traditional risk groups homosexuals, commercial
sexworkers or drug addicts. They state that the public must embrace or
at least accept members of these groups, or else HIV will never be controlled.
An example of this occurred at the conclusion of the International AIDS
Conference held in Chiang Mai in September 1995, when persons storming
the podium declared loudly that they were representing sexworkers, gays,
lesbians and transvestites of Asia. It was a powerful message gladly distributed
by the news media, linking these groups ever more closely to HIV/AIDS.
And so notions of epidemiology and culture clash, leaving the health of
the public in limbo.
The latest example of the link between a risk groups (in this case,
commercial sexworkers) and HIV/AIDS appeared in the sea-group posting (November
20) from the Jakarta Post, entitled, "Sex workers display photos." The
article describes a showing of photos by 15 photographers, members of a
group called Bandungwangi, who are attempting with their work to promotes
HIV/AIDS awareness in Indonesia. The sexworkers were reported to be sponsored
in their efforts by Yayasan Kusuma Buana, an NGO working in the field of
reproductive and maternal child health.
This group in 1993 was reported to have started an AIDS prevention program
for the sex workers in Kramat Tunggak, North Jakarta. Will the Bandungwangi
exhibit help bring social understanding and acceptance to Indonesian sexworkers?
Or will they further stigmatize HIV infected persons by linking sexworkers
to those who harbor the virus? It is difficult to answer these questions
from the vantage point of another society, but likely those of Indonesian
heritage will sense whether such actions promote or eventually harm the
image of HIV infected persons in their traditional, religious country.
If so, actions like the reported photo exhibit would make it even harder
for us to end the deadly shame and silence that surrounds this disease.