Countering stigma isn't easy

When Tebogo Masilo obtained a bursary to study archaeology in the United States he was overjoyed, but it didn't last long. As part of its regulations, the government demands an HIV test. "The results confirmed that I was positive and I did not get the scholarship," Masilo, 24, recalled. "They could not make an investment in me." Despite the existence of anti-discriminatory laws, the Botswana government introduced mandatory testing for overseas bursary holders about two years ago, but students wishing to attend the University of Botswana and other local higher education institutions are not tested. The move has been criticised by activists, who say it entrenches stigma and is all the more disappointing from a government that has been so proactive in the fight against AIDS. "The argument that mandatory testing is a necessary provision in avoiding costs incurred by government from students who die abroad, due to HIV, lost its validity when the government provided free [antiretroviral] ARV therapy for all Batswana, including those studying abroad," said Milikani Ndabe of the Botswana Network on Ethics, Law and HIV/AIDS. "By rejecting people who test HIV positive, we are saying that they are outcasts and not fit to be incorporated into society," noted Dr Dinesh Patel, a private medical practitioner. "This is not the best way to deal with the problem. We need a comprehensive policy to help curb the disease, rather than draw the line between those who have the virus and those who do not." Masilo's problems did not end with the loss of his bursary. He secured three promising job offers in Botswana, only to have them revoked, apparently when the employers discovered he was HIV positive - as are close to 40 percent of all Batswana. On paper, the Promotion of Equality and Prevention of Unfair Discrimination Act, promulgated in 2000, outlaws discrimination based on a person's HIV status. But, Ndabe pointed out, "what is lacking is a monitoring mechanism" to give the law teeth. The stigma surrounding the virus also means that some victims of illegal dismissal have preferred to keep quiet, rather than attract publicity by challenging the companies concerned. An initiative to draft a new policy on HIV/AIDS and employment, which will ultimately form the basis of future legislation, is being undertaken by the ministries of labour and home affairs, said Ndabe. In the meantime discrimination persists, and among the hardest hit are the least-qualified workers and migrant labour. "The practice still continues in informal sectors, such as domestic employment," said Oganeditse Marata, a lawyer based in Selebi Phikwe, a mining town north of the capital, Gaborone. Jennifer Joni, a lawyer with the AIDS Law Project, said an enlightened - and, in the long run, cost-effective - response from companies would be to provide treatment and support to their HIV-positive employees. "Companies can reduce their costs by investing in HIV prevention programmes designed to reduce the incidence of the disease in their workforce," Joni noted. The insurance industry was also ripe for reform, she pointed out. Despite a national treatment programme, HIV-positive people are handicapped when applying for financial assistance. Banks require loan applicants to hold life insurance policies covering the value of the loan, but life insurance companies require HIV tests as a prerequisite for coverage and legally reject those who test positive. The insurance industry still clings to HIV testing, notwithstanding anti-discrimination legislation. As in South Africa, insurance companies want to be exempt, arguing that compliance would cripple business. "People living with the disease cannot get a home loan to break free from the discrimination they suffer in their family's homes," said Mogapi Dineo, a counsellor at the Kopano Women's shelter project, which caters for abused women, some of them living with HIV/AIDS. Most of the residents of the Coping Centre for People Living With AIDS (COCEPWA) in Gaborone have sought refuge there from the stigma attached to the disease. "The society thought that we had got the virus because of being promiscuous. My family isolated me after I went public about my status, so I decided to come to COCEPWA," said Alice Moema. She believes that the only way to fight AIDS in Botswana is to build a movement of people living openly with the virus. "People are now somehow very scared because of this situation, and we can understand it. If people are going to be encouraged [to come out], they have to have the support," Moema remarked. "It is time that men and women in the first world, who are HIV positive, start establishing partnerships - just like governments do," she said. "To me, that's the most practical way to eliminate stigmatisation and discrimination."