30 November 2011: Stigma. Ignorance. Combined they make a powerful force that has challenged health professionals, social workers, governments and non-governmental organisations across sub-Saharan Africa since HIV and AIDS first became widespread, claiming lives at alarming rates. 

In nearly 30 years, more than 1,300,000 souls have been claimed by the disease, leaving 14,800,000 children orphaned. 

Today in Mali, where I live and work for Plan, nearly 80,000 cases of the disease are reported and 1% of adults aged 15-49 are HIV positive (WHO statistic).

Stigma threat

In the early years, the stigma attached to one suffering from HIV and AIDS and their extended family certainly exacerbated suffering and contributed to deaths. People were often afraid to take the test and learn their status, accepting the unknown risks versus being known as someone with the disease. 

There was a great, real fear of being cast out of communities. Individuals would suffer in silence, perhaps infecting others through their lack of knowledge. Husbands and wives unaware would infect each other and children would be born infected or left abandoned as orphans. 

While there has been no specific assessment conducted or tool elaborated to determine the impact of stigma, experts, health specialists, observers and the general public agree upon the changing stigma of AIDS over generations.

Changing behaviour

A family receiving HIV advice at a Plan-supported test centre in Mali

In Mali and elsewhere in sub-Saharan Africa, following a real focus on behaviour change, some communities have grown to accept, collaborate with and help those living with HIV and AIDS.  

Screening is an important part of the control strategy in Mali because it is the gateway for access to treatment and care. Screening is free and anonymous and available at nearly 200 locations in Mali. 

Plan assisted in creating or strengthening 179 of these testing locations, where patients can also receive counselling. These centres also help to educate the public about HIV and AIDS and raise understanding about how to prevent it and what to do if you become HIV positive.

Partners network

This is part of the national framework for AIDS in Mali which is supported by a strong network of partners and implementing agencies who work openly among citizens providing health care and prevention services.

The mark of stigma has been reduced through positive changes in behaviour. No longer is being HIV positive considered an immediate death sentence. This is partly due to the existence of and access to quality HIV-related services across the country including anti-retroviral treatment even in rural areas. 

Educating children

In my work with Plan, we engage children, the future generations to combat the spread of HIV and AIDS. Using peer-to-peer activities we have been able to educate children on the choices they must make to stay healthy and HIV-free. 

Plan also provides support to children orphaned by AIDS with schooling, making sure they have clothing, enough food and proper nutrition and emotional counselling.

With increasing knowledge about prevention and access to treatment, the fear, ignorance and stigma previously associated with HIV and AIDS continue to abate but we cannot afford to rest on our laurels and the fight to break down barriers continues.

Find out more about Plan’s work in Mali

Learn about Plan’s global work on sexual health