[procaare] HCC:Post Conference discussion -28

[Insight Initiative Team <insight@hdnet.org>]

HCC: Post Conference discussion - 28
- HDN Key Correspondents/Rapporteur Team,Thailand
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Confidentiality, Privacy And Coalition Efforts Against Discrimination

The development of mechanisms to protect the human rights of PLHAs remains difficult and
elusive, but there have been some success stories. Strategies discussed during this well
attended session included disclosure, community and government involvement.

Dr Somsak Supawitkul, Provincial Health Office, Chiang Rai discussed the role of
government hospitals in the care of PLHAs. He presented a diagram illustrating the flow of
services offered to those who disclose their HIV status and those who do not disclose.
"Disclosure leads to increased access of care and channels for referral" he said.

It has been noted in a number of studies that health worker's attitudes have been a
barrier to care. PLHAs have reported cases of discrimination at the hands of health
workers. A Human Rights Working Group supported by the Enhancing Care Initiative,
conducted a community- based study entitled Human Rights Aspects of Enhancing Care
Initiatives for PLHAs in Northern Thailand.

The strength of the study was that apart from being a community based research study, it
was also multi-sectoral and involved all the major key stakeholders namely, an academic
institution- Faculty of Nursing of Chiang Mai University, government- Chiang Mai
Provincial Public Health Office, civil society- AIDS network Foundation, faith based
group- The Church of Christ in Thailand and the Network for PLHAs.

The study used participatory and interactive research methods, which included the People
Research and Development (PR&D) Approach. This approach empowers communities through self-
reliance by identifying potentials and resources within the communities. The groups
identified and discussed their potentials together and this increased the respect between
the health workers and the PLHAs, which in turn helped the PLHAs to deal with problems of
self-stigma.

The community approach to fight stigma was reported to have worked successfully in the
Ryan White Comprehensive AIDS Resources Emergency Act (CARE) case study. Arnold Doyle gave
a description of how the USA government responded to advocacy efforts of AIDS activists by
passing the Ryan White CARE Act. Arnold said, " The outcome of the Act was that, stigma
and discrimination were reduced. Government acknowledged the role of Volunteers in the HCC
and the relationship between the community and the Public Health Department improved."

The need for respect and being heard is essential for all women. This is even more so if
the women are HIV positive and are illegal immigrants. Nadia Oprandi from Italy presented
a paper on implementation of strategies to prevent mother -to child transmission among
immigrant women in Europe. At times being an immigrant meant being labeled 'infection
vectors' of HIV. Expecting and getting respect in a situation where one is blamed is
almost expecting too much out of life. These women suffered double discrimination. The
study demonstrated that they needed information on HIV/AIDS, to be understood, respected
and protected. Institutions that offered them health care had the mandate to maintain
confidentiality about their HIV status.

In conclusion, the moderator of the session remarked that although there are some success
stories to the fight of stigma, there is still a lot of advocacy work to be done around
accessing prophylactic treatment for rape victims and health workers who receive needle
stick injuries. During the advocacy work, some groups of people put their lives on the
line especially in countries where any challenge to the system is seen as political
opposition. Arnold added that advocacy for passing of the Ryan White Act was a long
process, which involved long aggressive advocacy work. Fighting discrimination is a war.

HDN Key Correspondent Team
Rapporteur Team
E-mail: correspondents@hdnet.org

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The Insight Initiative Project is managed by Health & Development Networks (HDN) in
collaboration with the Thailand Red Cross Society, the World Health Organization and the
Royal Thailand Government, with financial support from AusAid and UNAIDS.

For more information about this project (the 'Insight Initiative'), visit the HDN website
at: http://www.hdnet.org

Fifth International Conference on Home and Community Care for Persons Living with HIV/AIDS
Chiang Mai, Thailand - 17-20 December 2001
Website: http://www.hiv2001.com


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