Uganda has long been lauded for its proactive response to the HIV/AIDS epidemic, achieving significant reductions in prevalence and working towards UNAIDS 95-95-95 targets. However, the nation success faces the persistent, stubborn roadblock: HIV-related stigma. Despite high levels of awareness and widespread access to treatment, stigma remains a structural, cultural, and psychological barrier that fuels the epidemic, hampers treatment and violates the human rights of people leaving with HIV(PLHIV).
The Anatomy of Stigma in Uganda.
Stigma in Uganda is not merely emotional; It is a profound social process. It is often manifested in two forms.
- External/enacted stigma: Gossip (reported by 60%) of respondents in a 2013 survey), verbal harrasments, neglect and fear of social judgment.
- A 2015 study by NAFOPHANU revealed that over half (54%) of participants experienced some form of discrimination on prejudice misconceptions, where HIV is still inaccurately associated with witchcrafts or immorality.
Impact of stigma on HIV Prevention
Stigma directly undermines efforts to prevent new infection, creating a culture of silence that allows the virus to spread undetected
- Avoidance of testing; Fear of a positive diagnosis and the subsequent social rejection stops many Ugandan from seeking voluntary counseling and testing.
- Lack of disclosure: Stigma discourages individuals from disclosing their states to partners or families, increasing the likelihood of unintentional transmission./re
- Reduced prevention update: Marginalized groups, including adolescent girls and people in high-risk groups may avoid preventive services to fear of judgment by health workers.
Barriers to treatment and cure
For those already living with HIV, stigma is a major obstacle to long-term health.
- Delayed treatment initiative: Many people wait until they are critically ill before seeking medical attention to avoid being seen at clinic, which accelerates disease progression.
- Poor adherence: Internalized stigma can lead to poor mental health (depression, stress), leading to missed doses of antiretroviral therapy (ART), which in turn compromises viral suppression and increases the risk of drug resistance.
- Loss to follow-up: Fear of stigma particularly in local communities leads to high attrition rates in treatment programs.
Special vulnerabilities
While stigma affects everyone, it is disproportionately felt by;
- Youth: Adolescents face severe self-stigma and rejection hindering their school attendance and social participation.
- Key populations: People who use drugs, sex workers and men who have sex with fellow men face heightened stigma, requiring specific one-stop centre initiatives, such as those run by the Makerere university joint AIDs program (MYAP)
Countering the stigma: Ongoing efforts
Despite the challenges, Uganda has shown resilience.
- Support groups and advocacy: PLHIV networks like NAFOPHANU have been crucial in providing support, reducing self-stigma and empowering individuals to stand against discrimination.
- Policy initiatives: The government has prioritized stigma elimination through the presidential fast track initiatives on ending AIDs, aiming to improve rights-based approaches to HIV care.
- Community-Based interventions: Projects like group support psychotherapy (GSP) have proven effective in reducing depression and improving mental among HIV patients.
- Cultural engagement: Innovative, arts-based, and cultural storytelling methods, such as those employed in Northern Uganda are helping to address the root causes of stigma by re-engaging community elders.
CONCLUSION
Stigma is the hidden hand that continues to drive the HIV/AIDs epidemic in Uganda. While the country has made strides in providing medical solutions, the battle against the social disease of stigma requires more robust, multifaceted approaches to truly achieve the 95-95-95 targets, the fight against HIV must be as much about changing societal attitudes as it is about delivering treatment.
Unlike back then when the HIV/AIDs had no available official treatment and many people fell victim of herbalists and self-appointed doctors for example the famous NANYONGA’s MIRACLE CURE
Yowanina Nanyonga, an elderly peasant woman based in Ssembabule, in the greater Masaka District of Uganda, who became famous in 1989 for claiming that God had revealed to her a “miracle soil” that cured AIDs.
The incident took place during the height of the HIV/AIDs panic in Uganda, a time when there were no available antiretroviral drugs, leading to widespread fear and desperate searches for cures.
THE STORY OF YOWANINA NYONGA
The vision: Nanyonga claimed that on the night of September 8th, 1989, she was visited by a divine light and a voice that instructed her to feed the “blessed soil” from her compound to the sick to cure them.
The cure: She claimed the soil could cure all types of illness, particularly HIV/AIDs, which was ravaging communities.
The crowd: News of her miracle cure spread quickly attracting thousands of people daily to her home including high-ranking officials and foreigners. It was estimated that over 50,000 people gathered at her farm between September and December 1989.
The action: Desperate patients drug up and ate large amounts of soil from her compound.
Government intervention: Due to the risk of disease spread and the lack of scientific evidence, the minister of heath at that time, Zach Caheru, ordered her to stop in October 1989.
THE CONTEXT OF THE TIME
AIDs epidemic: By the late 1980’s, Uganda was considered the epicenter of the African AIDs crisis, with thousands losing their lives and families being left destitute.
Desperation: Because official treatment was unavailable, people turned to traditional healers and religious faith healers.
Nanyonga was not the only person claiming a cure, but she gained the mist popularly.
Skepticism: While many believed, others including the media accused her of peddling false hope and endangering people as many of her “cured” patients died later. Yowanina Nanyonga passed away in 2000, but her story remaining a significant part of the history of the HIV/AIDs epidemic in Uganda, illustrating the desperation and fear of that era.
