Coping with the Challenges of AIDS: The Experience of Persons Living with HIV/AIDS in Addis Ababa

Problem Statement: The kinds and scale of social responses to AIDS in Ethiopia have been more complex than for other epidemics; Persons Living With HIV/AIDS (PLWHAs) frequently face pronounced shame, stigma, and discrimination by their families and communities. In places where these responses are the rule, many people resist knowing their HIV infection status or are reluctant to change their risky behavior even after knowing they carry the virus, fearing that this would be interpreted as an admission of infection.

Methods: Using an anthropological approach, 35 PLWHA informants were selected from several institutions providing counseling and social services. Due to the sensitivity of the subject, great care was taken in selecting informants, which was possible because of the author's past employment at a counseling center and his close interactions with patients. In addition to participant observation, the author interviewed the informants using semi-structured interview guides in various settings and during different job-related activities carried out at different counseling and care centers.

Methods: Using an anthropological approach, 35 PLWHA informants were selected from several institutions providing counseling and social services. Due to the sensitivity of the subject, great care was taken in selecting informants, which was possible because of the author's past employment at a counseling center and his close interactions with patients. In addition to participant observation, the author interviewed the informants using semi-structured interview guides in various settings and during different job-related activities carried out at different counseling and care centers.

Results: The study revealed that the stigma attached to HIV/AIDS is one of the most crucial factors in PLWHAs' willingness to disclose their serostatus to their sexual partners. Their fears centered on stigma and rejection, dying and leaving their children, going through long painful periods of multiple illnesses, being disfigured or psychologically incapacitated, and becoming impoverished. It was difficult for them to change their sexual behavior even if their current practice endangered their partner. Responses by spouses and caregivers to PLWHAs varied considerably, from acceptance of the patient's predicament and support to family instability, separation of partners, and the eviction of the sick person from the house. These case studies also indicate that misconceptions regarding modes of transmission, prevention of infection, and stigma attached to HIV/AIDS have impeded the process of a positive and supportive response from society.

Conclusion and Recommendations: The strong stigma attached to AIDS and PLWHAs prevents patients from seeking care and support, and also from receiving optimum care under local conditions. Efforts to prevent the spread of HIV/AIDS and the provision of care and support services should be directed toward eliminating the negative stereotyping of PLWHAs and encouraging a more sympathetic attitude toward them. It is suggested that health education through the mass media be considered to promote positive attitudes in both home-based and institutional providers.