-Rudolph Brown/Chief Photographer
Women and girls march in support of an HIV/AIDS prevention campaign on Constant Spring Road, St. Andrew, in January 2004.

Ceila Morgan, News Editor - Gleaner/Power 106 FM

There has been a significant reduction in the level of stigma and discrimination among health-care workers towards persons living with HIV/AIDS (PLWHAs), according to DR. Kevin Harvey, coordinator of treatment, care and support for PLWHAs in the Health Ministry.

Dr. Harvey says the shift in attitude is largely due to changes in the perception of HIV over the last two years. "Attitudes towards patients in the health sector have changed remarkably with the increased availability of anti-retroviral drugs and training for health personnel." he told The Sunday Gleaner. Currently, of the estimated 4,000 persons who require treatment for AIDS in Jamaica, 2,700 have been registered for anti-retroviral drugs.

knowledge of the disease

A number of the island's doctors, nurses and social workers have also undergone HIV/AIDS training to increase awareness, as well as counselling techniques aimed at assisting persons infected with AIDS to maintain compliance with treatment regimen. The programme, which has been in place for the past three years, involves monthly training sessions.

Dr. Harvey, however, notes that the dramatic change in attitude among health-care workers towards HIV/AIDS is not reflected among persons in the wider society.

Earlier this year a survey, conducted by the AIDS Responsibility Project (ARP) in association with the Jamaica Employers' Federation, revealed that 13 per cent of employers indicated they would not hire an HIV-positive individual.

According to UNAIDS, "Tackling stigma and discrimination is fundamental to creating the kind of environment where people living with HIV/AIDS can flourish and contribute in a meaningful way."

Reduced discrimination

Nadine Brown-Patterson, nurse manager at the Maxfield Park Health Centre in St. Andrew, agrees that the level of discrimination among health-care workers has been greatly reduced. "Health workers are no longer fearful of contracting the disease just by touching or talking to PLWHAs," she noted. "Infected persons are now being treated like anyone else who has a disease, as HIV is becoming more widely accepted."

She believes the training of personnel has played a large role in the acceptance of persons with the disease. However, she stressed that universal precaution should not only be practised for PLWHAs, but for all patients." Emphasising universal precaution for PLWHAs is one way of driving the discrimination among these persons," she said.

At least 20 non-health personnel have also been trained as adherence counsellors under the auspices of the ministry. The counsellors form part of a team comprising doctors and nurses based at 18 sites - hospitals and clinics across the island.

Rose, who set aside her fashion designing career to become an adherence counsellor, spends much of her time visiting wards at a Corporate Area hospital to ensure that patients with HIV receive their medication and are properly fed.

Time demand

The demand on her time for support of PLWHAs leaves very little time for much else, she indicated.

According to Rose, "PLWHAs need someone they can confide in and often find it more comfortable to speak with adherence counsellors than nurses or doctors."

However, she was quick to point out that there were definite signs of improvement in the care meted out by doctors and nurses to PLWHAs.

"When we just started nurses were stand-off; now they seem more comfortable to deal with the patients. They no longer leave them in a corner of the ward. Even some ward assistants are now helping with the care of HIV patients." she said.

While acknowledging the improvement in the treatment of PLWHAs, by health-care workers, project coordinator for Latin America and Caribbean Council of AIDS Service Organisations, Samuel Martin, says there is still more that needs to be done.

"Some PLWHAs still stay away from clinics and hospitals because of the harsh treatment they receive," he noted. "But they will visit the various AIDS support organisations as they feel more comfortable there."

Name changed on request.