2.12 Stigmatization and Social Perceptions
2.12.3 South African trends in Stigmatization and Social Perceptions
Stigmatization behaviour(s) can be connected to the use of stereotypes in the South African context. Social stigma associated with HIV/Aids was perpetuated, in the Mbeki era, by the Government's reluctance to bring the crisis into the open and face it head on. This prevented many from speaking out about the cause of illness and subsequent deaths of family members leading to medical doctors recording (so-called) uncontroversial diagnoses on death certificates. According to Campbell (2003) the South African Government needs to stop being defensive about the pandemic and show backbone and courage if it is to face the challenges of associated with the HIV/Aids crisis.
HIV/Aids is often seen to bring shame upon PLWHA their family and/or the wider community. In the minds of the community it is often associated with behaviours such as homosexuality, drug addiction or promiscuity and can be seen as the result of personal irresponsibility (Kalichman & Simbayi, 2003). Unfortunately negative responses to HIV/Aids exist and feed upon and reinforce dominant ideas of good and bad with respect to sex, morality and illness underpinned by judgments about what are considered proper and improper sexual behaviours. Stangor and Crandall (2000) suggest that such stigmatization behaviour(s) may have purpose in protecting the self from a threat. They view this as particularly relevant in the South African context where
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multiple race and class structures could be seen to perpetuate stigmatization. They suggest that through social stigmatization, the individual can distance himself or herself from the disease or behaviour associated with the stigmatized group. Related to the topic of stigmatization and social perceptions is the issue of social context. Many HIV- positive people have engaged in prevention initiatives by declaring their HIV-status openly. Campbell, Foulis, Maimane and Sibiya (2005) conducted a study looking at how the individual’s social environment shapes or influences HIV-prevention programmes.
Three aspects of context are seen to undermine the effectiveness of such intervention:
stigmatization, the pathologisation of youth sexuality and negative images of youth. This study explored how different understandings of the causes and ways to manage HIV/Aids serve to stop the failure of HIV-prevention initiatives.
Abraham, (2006) explored identity change, the experience of living with HIV/Aids and how an individual can manage the social risks of HIV. The author also explored many of the issues around stigmatization, which cause people to avoid disclosing their HIV positive status. Findings indicate that mainstream cultural models lay the foundation for perceived risk of self-disclosure. There are various reasons for why it might be difficult to disclose HIV status. For instance double stigma is evident when HIV is associated with high-risk groups and behaviour which is disdained in a cultural sense (for instance, homosexuality in a rural African context).
According to Sarafino (2002) there are certain factors which contribute to HIV/Aids- related stigma. Fundamentally, because HIV/Aids is a life-threatening disease
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associated with sex, people are scared of contracting HIV because they will die and also because they will be perceived to be doing something sexually wrong (shameful).
The disease is thus associated with what are perceived as wrongful sexual behaviour(s) (such as sex between men and/or promiscuous sex). These behaviours are stigmatized in many societies, particularly patriarchal conservative contexts such as those found on the African continent. More factors that contribute are for instance, PLWHA are often thought of as being responsible for becoming infected with the retrovirus because they are at moral fault. Essentially, they have erred against moral norms by committing acts that deserve to be punished.
Together with the widespread belief that HIV/Aids is shameful, these images represent ready-made but inaccurate explanations that provide a powerful basis for both stigma and discrimination. These stereotypes enable some people to deny that they are likely to be infected or affected. It is interesting to note that HIV-positive women are treated very differently from men in many developing countries. Madlala (2001) states that, men are likely to be excused for the behaviour that resulted in their infection, whereas women are not (this is usually promiscuous sexual behaviour or having penetrative sex without a condom).
In October 1998, the Deputy President of South Africa Thabo Mbeki made the Declaration of Partnership against Aids, in which he called for an end to discrimination against people living with HIV. Less than two months later, Gugu Dlamini, an Aids
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activist in Durban, was beaten to death by her neighbours after declaring that she was HIV-positive on World Aids Day (Department of Health, 2006). In 2000, Justice Edwin Cameron of the South African court announced in a speech that he was HIV-positive.
The public response to this declaration was, on the face of it, largely supportive.
However, it must be stated that revealing HIV-positive status can have a negative effect on employment and housing opportunities, as well as social relationships (Kahn, 2004).
A study by Lindell and Perry (2004) revealed that only one third of respondents who had revealed their HIV-positive status were met with a fair or good response in their communities. One in ten said that they had been met with outright hostility and rejection.
When his son died of Aids in 2005, Nelson Mandela publicised the cause of his death in an effort to challenge the stigma that surrounds HIV infection. He stated that he wanted to give publicity to HIV/Aids and not hide it. He noted that this was the only way to make it appear acceptable as an every-day illness. The concept of otherness is also integral to the understanding of stigmatization, as people construct roles for themselves in relation to another. This can be part of a process of reaction that can be related to stigmatization or condemnation. Essentially, anyone who has the virus is different thus other people who are different have unsafe sex (not me). This difference is perceived in a negative way which leads to stigmatization and discrimination of those who are known to be HIV positive or who have Aids (Nel, 2003).