Making sense of the 80% drop in HIV related stigma
Monday, November 16, 2020

A survey released by the Rwanda Biomedical Centre (RBC) last week showed that stigma and discrimination (SD) against people infected with HIV/AIDS in Rwanda has dropped by 80 per cent in the last twelve months.

According to the new figures, Rwanda’s stigma and discrimination index stands at 13, interpreted as "very low”, according to the scale used by the researchers.

But how good are these figures, what has brought about this change, and are we there yet in regards to winning the battle against discrimination?

First, it should be noted that though the overall HIV stigma index in Rwanda was very low, these statistics are not homogeneous across all the components generated by the index.

So, the figures went on varying across the different components of the survey which included among others, HIV stigma in health service provision; internalized stigma and resilience; stigma related to human rights and effecting change; stigma experienced in the last twelve months.

For instance, the survey revealed an 80 per cent decrease of SD experience in last 12 months specifically regarding exclusion from religion activities, social gatherings, family activities, physical harassment or discriminatory gossip against people living with HIV (PLHIV).

For human rights-related issues, the findings of the survey showed an SD decrease of more than 50% regarding PLHIV rights abuse and forcing them to be tested for necessities like insurance, health care, or visas.

Speaking to The New Times, Dr Eric Remera the Acting Division Manager for HIV, Sexually Transmitted Infections and Viral Hepatitis at RBC, said the 80 per cent reduction is SD is good and he said that one of the reasons for such an achievement is that the country has a very good HIV program which among other things has done mass sensitization of the population in regard to the disease.

"The HIV program in Rwanda is ranked among the best in the world. Since it started many mass campaigns have been done to sensitize the population, and even our leadership has played a big role to reinforce laws,” he said.

He said Rwanda’s health workers are "much trained” and the government works closely with the network of People Living with HIV, an organization involved in the HIV program management from the national to the community level.

"That also impacted the stigma reduction,” he said.

According to the survey, all the respondents (over 900) said that stigma and discrimination in health services was very low.

However, Remera noted that there are some areas to improve for instance where stigma is fuelled by some other factors like age (for instance adolescents may face more stigma); and lifestyle for example, for people like sex workers.

The study says young people aged between 25-34 years (48%) experienced stigma during the last 12 months prior to the survey; and more women than men faced stigma; where 34.8% of sampled women reported stigma as opposed to 22.4% of the sampled men.

A 20-year-old female person living with HIV that spoke during the launch of the survey said adolescents are still facing stigma and discrimination,

"We are still facing stigma and discrimination about our HIV status. For example, some people ignorantly think that a young person born of HIV positive parents has to automatically be HIV positive,” she said.

The survey noted that the fear of people living with HIV to disclose their status to others was still prevalent especially among young people and women.

It recommended more efforts towards improving PLHIV’s knowledge on laws and policies that protect them.

According to a 2019 national survey, there were approximately 210,200 adults between the ages of 15-64 years in Rwanda who were living with HIV (prevalence 3.0%).

The prevalence was higher in women (3.7%) than men (2.2%) and 1.9 times higher in urban areas compared with rural areas.