When I first joined the CDC in the mid-90s, I didn’t have any preconceived notions about People Living with HIV (PLHIV). Today, after more than two decades of working with PLHIV, I can say, with some degree of authority, that they are just like any other person. There are extremely beautiful people with HIV, and there are also people with challenging personalities. However, who they are as human beings has nothing to do with their diagnosis.
I think a lot of the stigma about HIV stems from fear and are, often times, without basis. For instance, there used to be a regulation that bodies of deceased patients with HIV needed to be removed within a period of 24 hours. We found that there was no scientific basis for that, so we pushed for the regulation to be removed and it has since been removed. Together with organisations such as Action for AIDS Singapore, we try and campaign for the removal and change of regulations that have a non-scientific basis. The latest de-stigmatisation measure that has been implemented is the removal of the requirement to have HIV listed on a person’s death certificate. If the person does not die from an HIV-associated condition, there is no need to indicate HIV on the death certificate.
We are certainly on the right path towards de-stigmatisation of the disease. We cannot completely remove the stigma, because there will always be some who refuse to accept logic or science. But, what we can do is to try and impart to people the right knowledge about HIV. We want people to know that patients with HIV do not require special precautions in healthcare. If they require special precautions, it’s because of other infections such as tuberculosis or diarrhoea, which someone without HIV would also need to take.
Much of what remains today is self-stigmatisation. This is where peer support can really help. Recently, we had a newly diagnosed patient who felt very lost and was not engaging well with our healthcare initiatives. I then introduced him to another patient in the same ward who had been diagnosed with HIV several years earlier. It was the support from this fellow patient that helped him to make a breakthrough. This was something that even I as a doctor could not do.
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