The Effect of Stigmatization (Theological Perspectives)

         The Effect of Stigmatization

People do not want to bear the weight of stigmatization so they change their behaviour. They decide to be silent about their status, and this has simply encouraged the virus to spread. In countries where admitting to a homosexual orientation remains socially unacceptable or even dangerous, the crisis can only get worse. In most developing countries, HIV became associated with sex workers, instead of with homosexuals. It was regarded as a product of promiscuity, which in turn led to silence and ever-increasing infection rates.

As with all sexually transmitted diseases, irresponsible sexual behaviour has been a factor in the increase in HIV prevalence. However, this is not a valid reason for rejecting HIV-positive people. How people contract the virus should not determine the attitude of the church – or of society – to their suffering. In secular circles, stigmatisation of HIV-positive people arose out of a sense of shame or guilt. It is an illness that is usually transmitted sexually and often leads to death. Since sexuality itself is often associated with shame and guilt the inclusion of death and fear made it worse. It is important to note that stigmatization is not always imposed on people. There could be self-stigmatization; a personal conviction that the infected person is an object of shame, or a sinner could be equally disturbing.

Apart from the non-Christian approach to HIV, Christians in the 1980s were faced with a new teaching that HIV was a punishment from God to the sexual immoral. The unexpectedness of the new disease and the speedy rate of its destructiveness could give reason for such assumption, comparing it with the plagues which God visited on his enemies in Exodus 7-12. However, the idea of HIV/AIDS epidemic being a form of divine punishment was not totally an acceptable claim. Yet many evangelical groups were eager to accept it in different parts of the world like in Europe and North America. It also gained ground in some traditional societies of developing countries; people who sought an explanation (such as bad spirits) for any kind of misfortune easily accepted that it is a misfortune or punishment from God.

Dr Michael Burke, of the Anglican Church of Tanzania Health Unit, has challenged churches to accept their role in combating stigma. He argued that ‘The churches have been the key maintainers of stigma while also having the capacity to address it.’ Christians who discovered that they were HIV-positive also preferred to remain silent. These accusations that are used to brand people in itself was injustice. Some infected men and women who knew themselves to have been faithful wives or husbands, being branded a sexual sinner, as well as being afflicted with a deadly condition, was hard to bear. Therefore it becomes a better choice to keep to themselves.

Theological Perspectives

Christian churches have engaged in pastoral care in all aspects of human experience: education, healthcare and social justice among many others. Therefore, they are in a good position to participate in HIV prevention and care at all levels. In many countries, churches are already deeply involved in this work. There is, however, a need for churches and Christian agencies such as Christian Aid to formulate the theological principles that determine their response to the epidemic if this is to be seen to be well-founded.

The widespread theological debate in the 1980s that HIV was a punishment from God for immoral behaviours made people who found themselves infected to keep status hidden in order to avoid stigma and rejection by their church and family members. But with time, people began to understand the causes of the spread of HIV better. Its links to poverty and injustice became better understood. People began to understand that HIV could infect anyone, regardless of their faith, marital status, sexual orientation or social position. Churches began to accept that the role of the church was to proffer solution and support to the already distressed people, not to condemn them.

          The Need for a Theological Framework

The need for a theological framework that facilitates discussion on the nature of God and his relationship with humankind (including people living with HIV/AIDS) became important. The model proposed here is based on Karl Barth’s work. It reflects the love of God and His involvement in the well-being of his people since the beginning of the creation. This is to say that the death of Christ on the cross for the redemption of the whole world is equally significant to those people living with HIV. If covenantal relationships between God and his people  are to be restored and maintained, the various forms of injustice that underlie the spread of HIV have to be addressed. Foremost among them is stigma, which all too often leads to dangerous silence, as well as rejection.

Gender injustice also has to be tackled urgently. Women now make up nearly half the total number of people who are living with HIV/AIDS worldwide. Women are vulnerable because of poverty and their need to provide for their children at whatever cost. They are at risk of rape and abuse. They may lack the freedom to negotiate safe sex with their husbands. Cultural restrictions could also make them suffer discrimination.

Injustice must be tackled to control the HIV/AIDS epidemic. There is the need to restore hope to these people who may already have condemned themselves. To do this, the silence has to be broken. These people should enjoy both material and spiritual assistance to enable them live a normal life. This means issues such as suffering and sexuality should be openly and positively addressed. For the church, this involves enabling people to behave responsibly by providing teaching about HIV prevention. It also involves the church itself acting responsibly in terms of its theological response to the epidemic and the quality of spiritual care it offers to people infected and affected by HIV.

HIV/AIDS presents a challenge to the church in its commitment to upholding God’s covenantal relationship with his people in every aspect of their daily lives. This challenge relates to the way the church sees itself and understands its mission as a healing, worshiping and prophetic community. Within the church, it is vital that everyone can feel welcome and receive pastoral support. Breaking the silence about HIV means integrating into worship the concerns of people living with HIV. Externally, in order to identify the most effective ways of combating the HIV epidemic, churches need to examine their relationships with other churches and faiths.

Finally, the church must make its voice heard in order to change the structures that are assisting the spread of HIV. Most crucially, this means working to alleviate poverty by advocating for change in unjust trade practices and the removal of the burden of unpayable international debt.

A theology of hope and love must be accompanied by practical care, which not only aims to improve people’s quality of life within their community, but also demands action in the wider world.

        Why Theology?

With the increasing danger of HIV epidemic which has become apparent over the past 20 years, the Christian community has seen the need to answer a call to service in tackling HIV issues through what is popularly referred to as ‘a theology of AIDS’. Countries in the developing world and beyond have come to terms with the reality that HIV/AIDS is causing great havoc in their midst. Hence, the clamour for a theological response has become a feature of the churches’ conversations and conferences.

The way the human immunodeficiency virus (HIV) spreads, and the devastating effects of the illnesses that result from acquired immunodeficiency syndrome (AIDS) have been felt to demand a response from the church and its leaders across the world. But why is this so? After all, no one could see a need for a theology of cancer or of malaria, the biggest killers in many countries. What then is so different about HIV/AIDS?

The answer may not be far from the understanding that the problems associated with HIV are more than any we can talk about. HIV is not selective. It affects the rich and the poor, adults and children, Christians and non-Christians. Whether acknowledged or not, since its outset, HIV has been present even in the church itself. It has affected congregations, priests and pastors alike. And suffering individuals are beginning to ask: where is God in all this? But that is not the same as seeking a theology that is specific to HIV/AIDS. This search implies that a theology of suffering, with which Christians have wrestled over two millennia, is not enough to address this epidemic. Besides the rapid spread of the virus, HIV/AIDS is also perceived to be different because of how it is transmitted. This has frequently been linked to behaviour of which the church disapproves. A significant factor in the now increasingly urgent demand for a theological response to HIV/AIDS has to be the spectacular theological error of the church in the epidemic’s early days.

In Western Europe and North America, HIV was first identified among homosexual men; while in other places, it was associated with female sex workers. Because of this, some churches were quick to say that AIDS was a punishment from God, similar to the punishment visited on disobedient communities in Old Testament times.

The church’s initial attitude rather fueled the fires of the epidemic instead of tackle it. Christians who became infected by HIV preferred to remain quiet for fear of the wrath of their pastors and rejection by their congregations. Therefore, HIV continued to spread very fast.

To this day, the ‘punishment from God’ theory still exists among some believers. In the 1980s, pastors in more remote communities in developing countries have yet to hear word of the churches’ change of heart. Some western conservative church leaders continue to hold this view because the idea of divine punishment fits neatly with their own world-view.

Subsequently, churches and governments began to break the silence surrounding HIV/AIDS. Today, instead of a theology of punishment, the church resorted to preaching about a God of love and compassion who does not inflict sickness on his people, and for whom illness is not to be equated with wrongdoing. For over two decades now, the church has been at the forefront of home-care provision and health services for people affected by HIV. The church now gives emotional and spiritual support. People involved in such activities, as well as the individuals and families who are infected or affected by HIV, need some kind of theological framework within which to do their work and live their lives.

       The Challenge to Theology

Many churches have begun to address HIV/AIDS in theological context, but most seem to be limiting their approach to a biblical studies perspective. This viewpoint is criticized as selective and Old Testament-based. It views the problem only as a ‘punishment from God’. Biblical studies are, of course, a crucial element in formulating a theological approach to HIV/AIDS. However, the Bible also has to be studied from a clearly articulated theological perspective. While it is good and right to comfort and encourage someone living with HIV by pointing them to Jesus’ love for outsiders, as shown in many of his healing miracles, theology also has to probe more deeply and widely. Clodovis Boff says “To address the question of where God is in HIV/AIDS, we need to ask. What is the nature of God as he is revealed through this epidemic? What does this tell us about the world as he sees it?” It will help to reveal that suffering should not be considered as all that God is willing give to his people.

In 1996, the World Council of Churches issued a statement about HIV/AIDS. It stated that ‘The church’s response to the challenge of HIV/AIDS comes from its deepest theological convictions about the nature of creation, the unshakable fidelity of God’s love, the nature of the body of Christ and the reality of Christian hope.’ It suggested that such convictions might be worked out in practice in a threefold model in which God who is Father, Son and Holy Spirit offers ‘a model of intimate interaction, of mutual respect and of sharing without domination’. This is an ideal that would be shared by those who are working with people living with HIV/AIDS.

         The Effect of stigmatization

Silence is the most dangerous effect of stigmatising people with HIV. Fear of stigma makes people afraid to reveal their positive status by changing their behaviour. This means that men and women continue to have unprotected sex, intravenous drug users continue to share needles, and HIV spreads faster than ever. Churches have often been accused of complicity in this silence. Archbishop Njongonkulu Ndungane of Cape Town has gone further by saying that ‘the church is to blame for the stigma and the spread of HIV/AIDS’, because a destructive theology linked sex with sin, guilt and punishment (emphasis added).

A second consequence of stigmatisation is that people who are not part of the stigmatised groups consider their way of life to be risk-free. In the UK, associating HIV with the homosexual community has led many people – especially young people who are particularly vulnerable because of their sexual behaviour – to wrongly imagine themselves to be protected. Stereotyping is dangerous, and not just for those who fit the stereotype.

Thirdly, stigmatisation leads to rejection. People who believe that HIV can be transmitted through touch, by eating food prepared by an HIV-positive person or by sharing their utensils, will reject anyone they know or believe is infected claiming that they are protecting themselves. This is a heavy psychological burden for the rejected individual.

Fourthly, the custom in many African countries makes families blame a widow for her husband’s death from an AIDS-related illness and throwing her and her children out of their homes. Rejection is not restricted to individuals, families or communities. In Haiti’s capital, Port-au-Prince, a recently established support group for HIV-positive people is campaigning against national and international discrimination. One of their members, Malia Malo, said that their aim is to end the refusal by some countries to accept residence applications from people who are HIV-positive. If a person discovers he is positive and is rejected by, say, the United States, it’s a double rejection. There is an effort to contact overseas networks to lobby international bodies such as the UN.

Jeanne Gapiya is one of the founders of Burundi’s Association of Seropositive People (ANSS). She first spoke out about her HIV-status at the 1995 World AIDS Day celebration in the Roman Catholic Cathedral in Bujumbura. ‘We must have compassion for people with AIDS’, said the priest in his sermon, ‘because they have sinned, and because they are suffering for it now.’ Jeanne can’t remember how she got from her seat to the front of the church. ‘I have HIV’, she said, ‘and I am a faithful wife. Who are you to say that I have sinned, or that you have not? We are all sinners, which is just as well, because it is for us that Jesus came.’

The effect of HIV on women in Africa was graphically described by Stephen Lewis, the United Nations (UN) Special Envoy on HIV/AIDS in Africa. Addressing a conference on microbicides, he said that the women of Africa run the household, they grow the food, they assume virtually the entire burden of care, they look after the orphans, they do it all with an almost unimaginable stoicism and as recompense for a life of almost supernatural hardship and devotion, and they die in pain. Because of poverty and gender inequality, women are not only particularly vulnerable to infection themselves; they also bear the consequences of the epidemic to a much greater degree than men.

       Women’s Vulnerability

Sheer economic need drives women into risky relationships in order to feed themselves and particularly their children.

If a family is in need, mothers may be forced to put their own daughters on the street. In Zambia, the Catholic Diocese of Ndola works with groups of young people to develop educational plays and presentations on HIV/AIDS. One of their plays focuses on exactly this situation. A mother sends her only daughter onto the streets because her father is too drunk to provide for them both. When the girl becomes ill, the mother blames her husband for the infection because he has previously put their daughter at risk by sending her out at night to buy beer for him.

There are the countless women and girls worldwide who have been infected with HIV as a result of rape. There are young girls who have been sexually abused by relatives and acquaintances, and so on. Stephen Lewis uses dramatic language to describe the plight of women: ‘It goes without saying that the virus has targeted women with a raging and twisted Darwinian ferocity. It goes equally without saying that gender inequality is what sustains and nurtures the virus, ultimately causing women to be infected in ever-greater disproportionate numbers.’ He is scathing about the international community’s failure to acknowledge women’s vulnerability over so many years: ‘The reason we have observed – and still observe without taking decisive action – this wanton attack on women is because it’s women.

      Human Rights Contributions and the Role of Women in the Fight against HIV/AIDS

Once again, injustice and unjust relationships are found at the heart of the spread of the HIV/AIDS epidemic. Gender discrimination is not the only human rights issue that affects women. Health ministers from 13 African countries recently appealed for Africans to get access to anti-retroviral drugs. This, they said, is ‘a new human right which the world has yet to accept.’ Since women now represent nearly half of all people living with HIV worldwide, being denied the right to the most effective treatment clearly affects them most. Women are not just disproportionately vulnerable to contracting HIV themselves. They also bear the brunt of caring for people infected or affected by HIV/AIDS, as well as becoming the main breadwinners. This burden affects women from childhood through to old age. Young girls risk being taken out of school to care for a sick relative or to contribute to the family income. Widows are left to bring up their children on their own. Grandmothers find themselves caring for any number of grandchildren once their own children succumb to HIV.

And in communities with health and education programmes aimed at combating HIV and caring for those affected, women usually make up the majority of volunteers. There are many inspiring stories about women who have undertaken such tasks with extraordinary dedication and success. However, this should not be allowed to obscure the underlying injustice of their situation. It is not simply that they live in societies where women are expected to bear this immense burden of caring and providing for others. What also needs to be challenged is the injustice at national and international levels that has landed them in the current crisis. For example, why will a young girl sleep with a teacher or an older man in order to pay her school fees? The underlying question should be: why does she have to pay fees at all? The answer lies in the international debt that prevents so many countries from providing free education.

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