By Stanslaus Madende
SINCE the discovery of HIV in 1981, billions of capital has been invested in fighting the virus.
Whether medical scientists and health practitioners are satisfied with the return on the investment or not is debatable, but the fact remains: HIV remains the greatest public health challenge. In addition, the current events show that the HIV challenge will still be with us for some time to come.
In my own opinion, one of the major stumbling blocks in the fight against HIV is that more often than not is that our society tends to view the issue of HIV as a moral one.
I am convinced that this moralistic view is wrong. Society needs to stop treating HIV as an issue of morality, but rather as a public health epidemic, destroying individuals, families and the community at large.
I am pharmacist by profession and I do not profess any expert knowledge on morality, but let me briefly explore what I understand about morality.
From Wikipedia, morality (from the Latin word moralis) is the differentiation of intentions, decisions and actions between those that are distinguished as proper and those that are improper.
Morality can be a body of standards or principles derived from the code of conduct of a particular philosophy, religion or culture, or it can derive from a standard that a person believes should be universal.
In summary, morality is specifically synonymous with ‘goodness’ or ‘rightness’. Therefore, morality does not imply objective claims of right or wrong, but only refers to that which is considered right or wrong.
The bottom line is that morality borders on judgement. Therefore, it’s either about something being ‘right’ or ‘wrong’. The judgement factor cascades either downstream or upstream, on any subsequent events or actions.
For example, if a thief is identified in the community, everyone agrees it’s wrong to steal, and as such, the person must be punished. No one would want to be associated with that person, in case one also is labelled as a thief, or as an accomplice. The person becomes a community misfit, because he/she has done something wrong. Morally it’s wrong to steal and whatever the punishment/community retribution is, it is, therefore, justified in the context of morality.
In such instances, you hardly come across community members with a rehabilitative reasoning/approach, because it’s wrong to steal, and therefore, the person deserves whatever punishment or retribution from the community.
Historically, HIV is correlated with promiscuity and promiscuity is morally wrong in all cultures of this world, as far as I know. Once someone is judged to have done something wrong, then everything changes, either going forward or backwards.
As far as HIV is concerned, from a moralistic approach, someone must have done something wrong to acquire HIV. The judgemental effect and scrutiny is a game-changer. HIV patients are very much aware of this moralistic scrutiny and judgemental view towards HIV, because they are part and parcel of the same society.
With this knowledge in mind, the society moralistic view of HIV is thus the beginning of stigmatisation, feelings of isolation, lack of self-esteem, lack of self-efficacy and the perceived exclusion from sexual intimacy, and community rejection.
Somehow the individual also feels that he/she has done something morally wrong or he/she is morally weak, based on society perspectives.
Let it be known that health practitioners (medical doctors, nurses, pharmacists, laboratory scientists and social workers etc.), who are at the forefront of fighting HIV, are part and parcel of the same community. Yet they tend to take a back seat when HIV issues are discussed in the community. The perceived judgement and historical behavioural scrutiny of HIV patients greatly compromises efforts to fight the pandemic. The patients feel rejected, remorseful and feel like a living black spot in society. In actual fact, they live in ‘fear’, as HIV makes them feel like strangers and aliens in their own society.
Who can forget the statement of former Philippines President Gloria Macapagal Arroyo, who boasted that the low infection rate in her country was the result of Filipinos practicing “high morality”?
So does it imply that people living with HIV/Aids are morally weak? And countries with high rates of HIV/Aids are morally reprehensible?
I completely disagree and I am sure there are lots of HIV enthusiasts out there who disagree as well. In addition, the moralistic view of HIV/ Aids has, of late, been worsened by social media. It’s a fact that social media thrives more on circulating jokes or skits. There are jokes that circulate on social media centred on HIV, which are in bad taste, particularly for people living with HIV.
We must learn to love, respect and accept ourselves – flaws and all. By doing so, we begin to free ourselves from the confines of morality judgment and the scrutiny of HIV. Morality and health do not mix at all.
Once someone is diagnosed with HIV, let’s take it as a springboard to move forward in the context of public health, rather than putting a rear view mirror and setting up a kangaroo moral court. Even Jesus Christ never asked his disciples about their past, upon their recruitment, but was only interested in their commitment going forward.
People can make excuses and justify a reason for every other issue of morality, but how dare we talk about health in the same manner. As scientists toil and moil in their exploration of various fields of knowledge, in search for a cure, our society must be inclusive and have empathy for everyone, regardless of their health status.
Various churches, from the beginning, have been reluctant to embrace efforts to fight HIV, because of their moralistic view of the HIV issue. However, after intense lobbying by various stakeholders, they have embraced some of the efforts, albeit with pinch of salt. Why? This is because churches often assume a link between HIV and what they regard as sinful activities, based on the HIV morality thinking of the Christian doctrine. I totally don’t agree with church leaders, who say that HIV is the wrath or judgement of God.
No wonder some countries have drafted or are drafting legislation that seeks to criminalise the transmission of HIV, motivated by the moralistic approach.
There is a real danger that the criminalisation of HIV transmission may produce consequences that are not only naturally unjustifiable, but also unhelpful, in terms of public health aims. The irony is that the laws are discriminatory, as they target only HIV patients on treatment, because from a public health perspective, they are the only ones who know their HIV status and thus they are the ones who can “deliberately infect the uninfected”. Let’s be clear, in no way am I suggesting that those purposely infecting others with HIV should not be held accountable and punished justly for their behaviour, because they should. After all, failure to disclose your HIV status to future sex partners, and/or knowingly infecting someone with HIV, is considered to be a felony in many countries. However, I am saying that everyone must also be held accountable and responsible for their own sexual health.
We need to get our heads out of the clouds, stop turning up our moral noses on health issues, climb down off our moral high horses and instead of judging HIV patients, focus on HIV prevention and treatment trajectories, and normalise conversations about HIV. After all, HIV is just a virus
*Stanslaus Madende is a biomedical pharmacist, who is working in the public health sector. The views expressed here are entirely his personal opinions, and he welcomes other opinions as well. You can contact him at stanslausmb@gmail. com or on +264 81 361 3699
Confidente. Lifting the Lid. Copyright © 2015