A Valentine reminder that people with HIV deserve love
Good health care not same as ending stigma
Six years ago, Pete learned that he was HIV positive, a point in his life when he struggled to understand what this meant and had almost given up on life. However, this is where his story begins. Pete managed to overcome the stigma and discrimination and decided to publicly disclose his HIV-positive status on social media and educate people about HIV from his experiences, becoming today an influential voice in Thailand.
On this Valentine's Day, as part of its continuing efforts, the United Nations affirms -- everybody deserves love, respect and dignified lives. People living with HIV are valued members of our communities who are making enormous contributions to society.
The network of people living with HIV is actively working alongside government and the UN to promote HIV testing, advocate for prevention campaigns and tackle discrimination. All of us can do more to support their efforts.
That begins with countering stigma and discrimination that still pervades all sectors of society. People living with HIV continue to face stigma and discrimination everywhere: at work, at school, at home, in health settings and in the community.
Stigma Indexes conducted in different countries around the world show that there are still people who do not want to buy food prepared by people living with HIV, or parents who do not want their children to attend school with students living with HIV. These ideas and attitudes are deeply founded in ignorance and put the lives of people living with HIV in danger, with clear findings that people do not access needed health care because of many types of stigma and discrimination.
To this day, there are still many misconceptions about HIV. The virus cannot be transmitted through saliva, tears or sweat and can only be found in body fluids, such as blood, semen, vaginal fluids and breast milk. For example, hugging, shaking hands, sharing toilets, sharing dishes and kissing do not transmit HIV. It is transmitted through penetrative sex, blood transfusions, the sharing of contaminated needles and drug injection, and between mother and infant during pregnancy, childbirth and breastfeeding.
Several methods have proved highly effective in reducing the risk of HIV, including male and female condoms, the use of antiretroviral medicines as pre-exposure prophylaxis (PrEP), and treatment of people living with HIV to reduce viral load and prevent onward transmission.
There are also misconceptions about the health situation for people living with HIV, with ARV treatment- having life-changing benefits. Treatment enables people living with HIV to stay healthy, maintain their quality of life and have a lifespan similar to those who are not living with HIV.
Thailand is at the forefront of the HIV response with a strong public health system that provides antiretroviral treatment (ART) covered by the Universal Health Coverage Scheme.
Twenty years of evidence shows that HIV treatments are highly effective in reducing transmission, with clear findings that people who have an undetectable viral load cannot transmit HIV sexually. This is life-changing for people who feel liberated from stigma associated with living with HIV and can provide a strong sense of being agents of HIV prevention. Thailand has also made considerable progress curbing mortality associated with HIV, with a 44% decline of Aids-related deaths from 2010 to 2019, from 25,000 to 14,000 respectively.
Yet considerable challenges remain. The country has one of the highest prevalence rates in the Asia-Pacific, with an estimated half a million people living with HIV. While infections are dropping, they are rising among young men who have sex with men, and rates of other sexually transmitted infections are also increasing.
"It's not that having HIV is normal -- HIV is not normal," said a youth representative from the Thai Network of Youth Living with HIV, who asked not to be named. "But people living with HIV are normal. They have potential like other people and should be treated and be loved like others." She added that normalising HIV does not mean ignoring safer sex and practices.
The epidemic disproportionately affects key populations, often those who are already subject to stigma that pushes them to the margins of society and aggravates public health risks. Men who have sex with men are the most impacted group, accounting for about 38% of new infections. Sex workers and their clients, transgender people and people who inject drugs each account for about 5 to 10% of infections, with migrants and prisoners also disproportionately vulnerable. Almost 50% of new HIV infections, or about 3,000 per year, are in young people aged 15 to 24.
In many cases, people living with HIV avoid visiting health care settings because of stigma and discrimination. A 2014 National Examination survey found that 59% of the general population reported discriminatory attitudes. This must change. Stigma and discrimination fundamentally undercut not only Sustainable Development Goal (SDG) 3 on health and well-being, but all the 17 interlinked SDGs and the country's development trajectory.
Pete has made it his life mission to educate people about HIV prevention and to reduce the HIV transmission rate.
His work, however, needs the support of all of us, which begins with informing ourselves about HIV to end ignorance, stigma and discrimination. Only then will we have a truly resilient and healthy society.
Gita Sabharwal is the UN Resident Coordinator in Thailand and Patchara Benjarattanaporn is UNAIDS Thailand Country Director.