DURBAN: The HIV-positive not only have to deal with external stigma but also the internal stigma they impose upon themselves when learning their status, Constitutional Court Judge Edwin Cameron said yesterday.
In an impassioned lecture to a full audience at the International Aids conference in Durban, Cameron said that internalised stigma was “the unexplored epidemic”.
“This ostracism and dread, this prejudice is in our own minds. This internalised stigma has its source in self-blame and deadly fear. We must find solutions to this, we must look at society in this context when looking at how HIV is transmitted.”
He was delivering the Jonathan Mann Memorial Lecture on protecting human rights and reducing stigma. Mann, who died in 1998, was an American humanitarian and founding dean of the School of Public Health at Drexel University in Philadelphia.
Cameron said it had been 35 years since the world was alerted to Aids when it was first reported as “a mysterious and deadly illness” in May of 1981.
“Aids exposes us to all our human vulnerabilities; it takes its toll on our muscles, our flesh. It takes its toll on our brothers, our sisters, our parents and our colleagues.”
Despite this, he said, it was important to pause to triumph over the evolution of activism, science and health care.
“The reason that I am here today is because of science and activism.”
Judge Cameron started on antiretroviral medication (ARV) 19 years ago and said he “sought no credit for survival. It seemed the necessary task”.
He paid tribute to the Treatment Action Campaign (TAC), a South African advocacy group founded in 1998 that strives to ensure that “every person living with HIV has access to quality comprehensive prevention and treatment services to live a healthy life”.
The judge said it was because of the TAC’s “angry, principled, determined activists” that ARVs were made available to all South Africans.
Today, the TAC faces closure because of a lack of funding.
He said the TAC taught the country that solidarity and knowledge are not enough in the fight against HIV.
South Africa today has the largest ARV treatment provision programme in the world.
About 54% of those infected are on ARV treatment in southern and eastern Africa.
“Aids inflicts a staggering cost on the continent and world. There are 70 million people today on ARVs, but there are still far too many who are not receiving them.”
Judge Cameron said that despite the progress made, the epidemic was still stigmatised and criminalised.
“Laws that criminalise the HIV-positive are vicious, misguided and evil. By criminalising exposure they ignore the science.”
Men who have sex with men (MSM) were also highly stigmatised and lacked awareness, outreach and provision of ARVs.
“Despite all of this knowledge, we are still failing MSM and particularly African MSM because of ignorance, prejudice, hatred and fear. The world hasn’t accepted that sexual identity and sexual orientation are part of being human.
“We gay men don’t ask for tolerance and acceptance, we ask for our right to be human. Discussions on identity and orientation are a waste of time.”
He said that sex workers were the most reviled group in history and yet they were “indispensible” to heterosexual men.
“Their work is work and they do their work with dignity. Why do they do it? For groceries, for school fees. It is hard, tough and dangerous work. They deserve our love and support and police protection, not assault and humiliation.”
He said criminalising sex work was “profoundly evil”.
Judge Cameron called the US war on drugs the greatest policy mistake of the last century, saying it was “denialist”.
“We know what we must do to tame the epidemic; we must empower young people, especially young girls. We must redouble prevention and education efforts, and we must test, test and test.
"We cannot promote consensual testing enough, it is the gateway to knowledge and treatment.
"HIV thrives on inequalities – gender inequalities, inequalities in access to health care, and inequalities in access to justice," said Judge Cameron.