AIDS treatment on rise, but stigma still around

With anti-AIDS drugs becoming widely available in Ghana, thousands of HIV-positive people are living longer, healthier lives but health workers say they continue to hide their status, frightened of rejection by friends, family and colleagues. The government began heavily subsidising antiretroviral (ARV) treatment for people living with HIV/AIDS after receiving a US $15 million grant from the Global Fund to Fight AIDS, Tuberculosis and Malaria in 2004. This year another US $6 million from the national purse was added. Some 2,600 Ghanaians are now receiving the life-prolonging medication. "Treatment is so readily available, unlike what pertained a few years ago - people who were on the verge of death are now looking healthy and going about their everyday duties," Eric Pwadura, an official at Ghana's AIDS Commission, told PlusNews. Although more people were receiving ARVs than ever before, it was still difficult to get a job and a place to live; even retaining relations with friends and family was not easy, according to Kakra Ankobiah, programme director of the West African AIDS Foundation (WAAF). The WAAF operates a hospice specialising in HIV/AIDS treatment and care, and also runs outreach programmes in the capital, Accra. "More people are alive today - thanks to ARVs - but no one wants to employ them; landlords or other tenants are evicting and ostracising people who openly reveal their status. These are problems we have yet to deal with as a society," said Ankobiah. While the Ghana AIDS Commission estimates that about 90 percent of Ghanaians are aware of HIV/AIDS, health officials concede that the stigmatisation of people living with the virus remains the biggest challenge. According to Sakyi Awuku Amoa, head of the commission, earlier campaigns inadvertently contributed to creating the problem by associating AIDS with death and focusing too heavily on the fear factor. "The epidemic of stigma, discrimination, blame and collective denial is making all preventative interventions ... very difficult," Awuku Amoa admitted. Patients and health workers agreed that enabling people living with HIV/AIDS to afford treatment, keep their jobs and not be dependent on their families could go a long way towards combating stigmatisation. "It all depends on the financial empowerment ... to support ourselves and our families, have our own accommodation without the fear of being ejected, and have a well-paying job," Haruna, a 38-year-old HIV-positive teacher, told PlusNews. He would never have been able to afford his medication without the government subsidies that allow him to spend 50,000 cedis (less than US $10) a month on ARVs: the commercial retail price of his treatment is between $800 and $850 - far beyond the limits of his $100 a month salary. "Only when we are empowered can you expect a majority of people living with AIDS to have the confidence to come out and make their status open," Haruna pointed out. WAAF hospice officials say most of their AIDS patients have been shunned by their families, who can't afford to look after them. "Our in-patient capacity is limited to 20 beds, and when the hospice is fully booked about 70 percent of all our cases are patients who have been dumped here by their relatives. They only turn up again after the patient is dead to collect the corpse for burial," Ankobiah told PlusNews. "But it is slowly easing up and people are beginning to accept their relatives' condition," said Ankobiah, whose clinic provides free treatment after payment of a 30,000 cedi, or US $3, registration fee. Nevertheless, Dela, 38, an HIV-positive teacher also on subsidised ARV treatment, said it would be unthinkable to declare her status publicly - she runs her own nursery school and any mention of AIDS would be bad for business. "I do not think it is time ... to declare my status, due to the possible negative repercussions that can come up," she affirmed. When her sister first found out Dela was HIV positive eighteen months ago, she urged neighbours to withdraw their children from the school. "Rumours went around, especially when I started the ARV treatment and initially lost some weight, but now it does not bother me. I know I have the disease and I just have to live with it. Fortunately, I have always been slim, and since I still go about my duties like any active person, the rumours have died down," Dela told PlusNews. Afua, 42, a foodstuff trader who lived in the next suburb, was not so lucky: she died three years ago - just before the government-subsidised ARV programme started. "When people realised she had the virus, they stopped buying her foodstuffs and she had to depend on her aged mother for her upkeep," Dela said. "As she grew weaker, prior to her death, she was confined to the outer room of her family's rented apartment with her own cup and plate, and prevented from going to the main bedroom area."