Abstract
HIV is a deadly reality in South African communities, where people living with HIV (PLWH) do not only face physical sickness but also severe stigmatisation. Literature shows that spiritual leaders (religious leaders/traditional healers) can have a very meaningful role in the reduction of HIV stigma. This article reports on part of a comprehensive community-based HIV stigma reduction intervention with PLWH and people living close to them, which included partners, children, family members, friends, community members and spiritual leaders. The focus of this article is on the experiences of spiritual leaders during and after the HIV stigma reduction intervention. The research took place in both an urban and rural setting in the North-West Province of South Africa and data collection was done by means of in-depth interviews with the spiritual leaders. The interaction with PLWH during the intervention activated new experiences for spiritual leaders: acceptance and empathy for PLWH, an awareness of their own ignorance, a stronger realisation of God’s presence and a realisation that they could inspire hope in PLWH. A greater awareness was created of HIV and of the associated realities regarding disclosure and stigma. The inclusion of spiritual leaders as well as PLWH brought about a positive shift in the attitudes of communities through the increase of knowledge and understanding of HIV stigma. They saw themselves playing a much greater part in facilitating such a shift and in reducing HIV stigma in their own congregations and their communities at large.
Highlights
Introduction and backgroundHIV remains a global issue, especially in Africa, which accounts for 25.7 million of the global estimate of 36.7 million people living with HIV (PLWH) (Joint United Nations Programme on HIV/AIDS 2018:16)
People living with HIV represent 12.6% of the total South African population (Statistics South Africa 2017:7), showing that HIV increasingly affects the lives of all South Africans (Gilbert 2016:10)
Three themes were identified during the analysis of the interviews with the spiritual leaders: Interaction with PLWH activated new experiences for spiritual leaders; an increased awareness of difficulties with HIV, disclosure and stigma; and the value of the HIV stigma reduction project
Summary
HIV remains a global issue, especially in Africa, which accounts for 25.7 million of the global estimate of 36.7 million people living with HIV (PLWH) (Joint United Nations Programme on HIV/AIDS 2018:16). HIV stigma influences every aspect of the PLWH’s lives, including ‘disapproval, rejection and sub-optimal services in health care settings’ (Joint United Nations Programme on HIV/AIDS 2014:12; see Gilbert 2016:11) It impacts on how the community interact with PLWH (Treves-Kagan et al 2016:87). A qualitative study in Limpopo, South Africa, by Norder et al (2015:1407) found that barriers preventing the involvement of churches in HIV healthcare are stigma resulting in non-disclosure, increased stigma because of the association between HIV and sexuality, and certain religious practices that interfere with adherence to medication They identified opportunities for health–religious collaborations, such as holistic HIV care to include spiritual aspects, utilising the church’s social access to the community and the potential of churches for HIV dialogue because they are identified as safe and accepting places (Norder et al 2015:1408).
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