No cure for society’s prejudice toward AIDS

Medical advances in the treatment of HIV/AIDS have changed a lot of deep-rooted and incorrect information. The disease, which used to be considered fatal in the early 1980s when it was first identified, has now been categorized as a chronic disease, like diabetes, by the World Health Organization, or WHO. With life-long treatment and the regular use of medicine, HIV positive patients can now enjoy a long and normal life.

Early diagnosis plays a key role in the treatment of the disease, but even if an HIV infection advances to the more serious AIDS phase, a patient can return to the earlier HIV-positive stage with medication if his or her vital organs have not been affected by the disease. Today, World AIDS Day, the world will focus on problems faced by HIV/AIDS patients and this year particularly on updating public information about the disease.

"The positive affects of medical advances are not visible in society. People are still prejudiced toward HIV/AIDS patients," Tekin Tutar of the Istanbul-based Positive Life Association, an organization that provides support for HIV-positive people, told the Hürriyet Daily News & Economic Review.

"Patients face discrimination, stigma and social exclusion from the moment they are diagnosed as HIV positive. They need support during the diagnosis and post-treatment period," he said.

Difficulties accessing treatment remains the most painful discriminatory act faced by HIV patients. Some hospitals, especially in smaller cities, delay or reject the treatment of HIV patients.

In some cases, patient-doctor confidentiality has been broken when their HIV positive status is highlighted in big, bold notes on files or over patient’s hospital beds.In society, they face similar problems. They are stigmatized, people even hesitate to touch them, thinking contact can pose a risk. Most prefer to keep their disease secret from their families, relatives, friends and work colleagues. They face the most problems when informing their families.

Discrimination still a major problem
"People are fearful and shocked when they learn someone they know has HIV/AIDS. It is only after being equipped with sufficient information about the disease they develop a more rational attitude," Tutar said.

"We are still living and treating HIV/AIDS patients who only know about the disease from information that was available in the 1980s. Unfortunately information currently available has not changed attitudes and prejudice toward the disease."

Kemal Y., 51, an HIV positive patient, faced discrimination during a five-month period of imprisonment. He was in prison on business-related matters and faced discrimination from prison officials and the prison doctor.

"I was isolated in a single room. I could not join in social events and nobody touched me. They did not want me at any prison so I had to go to three different prisons in my five-month sentence," he said.

"The doctor in the prisons would not treat me. In the last month, I was only able to stay at the same prison as I promised not to demand medical treatment."

He said he has faced similar problems in social relations and in hospitals outside prison, the lack of awareness about the issue was why people stigmatized HIV/AIDS patients. Another HIV positive patient, Tuncay A., 32, said the biggest problem he has is with the health sector as there are discriminatory attitudes in hospitals. He said he does not tell people he has the disease before making sure they are equipped with sufficient information.

"People do not need further information or need to update their knowledge about the disease unless they have the disease," he said. Many experts believe a general lack of information on HIV/AIDS and the false attitudes about the disease are major factors triggering social discrimination toward HIV/AIDS sufferers.

"The disease used to be known as a disease of ’bad men,’ such as homosexuals, gays and sex workers when it first appeared in the 1980s. Unfortunately we have not broken the stereotype. Contrary to common belief, the disease is usually transmitted through sexual intercourse between partners, not necessarily homosexual partners," said Dr. Aygen Tümer, coordinator of the Hacettepe University’s AIDS Treatment and Research Center.

Facts on AIDS need to be updated
"Some people think that by embracing or touching a person, the disease can be transmitted. A separate course on AIDS should be included in school curriculum. This occurs overseas," Tümer said.

There are currently 3,200 registered HIV/AIDS cases in Turkey and 900 patients undergoing medical treatment, according to Health Ministry statistics. The real number, however, is estimated to be much higher when including unregistered cases. As at June 2008, out of 3,175 HIV/AIDS patients, 2,206 are male and 969 are female. Contraction of HIV is largely caused by heterosexual transmission, amounting to 70 percent of cases in Turkey. Out of 3,175 cases, 1,851 people caught the disease through heterosexual intercourse, 266 through homosexual and bisexual intercourse, 131 through intravenous drug use and 53 from an infected mother. There are around 40 million people in the world living with HIV.

The treatment of the disease demands costs YTL 2,000 monthly, but those people who have social security can have free treatment. Those without can receive treatment using a green card. There is no problem for access to HIV pharmaceuticals in Turkey.

"The real problem faced by patients in the treatment process occurs when presenting their prescription to workplaces to receive payment for medical treatment," Tümer said. "Some people can not even begin treatment for fear their disease will be disclosed in their workplace and they may face discrimination." This problem is especially problematic for public employees.

The small number of hospitals that have an infectious diseases department for the treatment of HIV/AIDS patients is another problem, Tümer said. There are only 20 to 25 such hospitals in Turkey.

Nejat Ünlü, chairman of the Positive Life Association, said the dramatic increase in the number of HIV carriers in Turkey this year is concerning. Turkey usually has close to 200 new HIV cases annually, but in the first six months of this year there have been 250 new cases, the highest figure in the last 20 years.

"The trend is dreadful. It means around 500 new HIV cases in one year. The government should take this seriously and make the issue a priority," he said.