Jamra primary scholl for children affected by HIV/AIDS, drugs or poverty, Senegal (c) Nell Freeman/Alliance Participants in the Photovioce project, Ecuador © Marcela Nievas for the Alliance

Sustain treatment gains


Rehearsing a play about stigma which will be performed for traditional leaders © Gideon Mendel for the Alliance

Zambia is one of the 20 countries listed by UNAIDS where if intensified action were taken it would achieve the greatest impact on the HIV epidemic.

In Zambia, as in many countries around the world, stigma and discrimination are two major barriers to people accessing HIV prevention, treatment care, and support. They lead in many communities and societies to an abuse of human rights, particularly around the inability to access healthcare and employment.

That’s why ahead of the UN General Assembly’s High Level Meeting on AIDS on 8-10 June, the Alliance is calling on governments to sustain treatment gains, which must include removing barriers to access, and build on the capacity of community to deliver and support services.

Zambia’s community responses

In Zambia the Alliance has been conducting stigma training workshops to increase the quality of HIV programmes so that communities can be actively involved in achieving universal access to prevention, treatment, care and support.

Hundreds of people have received stigma training covering districts in Southern, Central and Western Province. Trainers are also trained in antiretroviral treatment (ART) adherence and based in health centres so there is a continuity of care between community caregivers and healthcare staff when working with people living with HIV.

Many of those trained are members of rural support groups and are living with HIV. Trainees are personally affected not only directly by HIV but by the high levels of loss and bereavement.

 ‘I lost my husband when I was 4 months pregnant. I felt so lonely. After a long time I found a support group where I was finally comforted by others…’

‘I lost my child when she was still young; the medicine was too much for her. She used to greet me every morning. I miss her so much.’

Both these comments are from people attending a stigma training workshop. For many people just being able to meet other people who can talk about their experiences is encouraging and empowering.

Once trained the trainers then disseminate the training through different outlets including church meetings, support groups and women’s groups, providing voluntary counselling and testing (VCT) and ART adherence counselling.

In just 6 months following one training course the trainers had managed to reach over 4,000 people with anti stigma messages

Ability to make a difference

What is clear, is that not only is the training changing attitudes to people living with HIV but also giving people a sense of power over their circumstances and an ability to make a difference in their society and to the health of their communities.

‘I lost my wife in 2006. I was taken from the Copperbelt back to the village in Mongu when I got sick. It was there that my father took me for VCT as they had been trained. I went to Mongu for ARVs and after one week the sores had vanished. Then I was trained by the home-based care support group and I am now in a drama group, sensitising others about HIV.’ 

In a country where HIV and AIDS is prevalent among the general population tackling stigma and discrimination is critical to support people living with HIV to access  treatment, care and support. With people reliant on it to keep them fit and healthy and contributing to society, the international community have a duty of care to not only continue but increase funding for treatment, care and support programmes otherwise many people will die unnecessarily.

Sustain treatment gains is 1 of 7 key Alliance messages calling on world leader to recommit to universal access targets. You can find all 7 messages here, along with case studies from around the Alliance.

Read more on the stigma reduction workshops

Download The True Cost of Stigma; an evaluation the Social Return on Investment (SROI) of anti stigma initiatives

Download Integrating stigma reduction into HIV programming; lessons from the Africa Regional Stigma Programme

Read: A blog reflecting on the Africa Regional Programme, including positive changes resulting from the stigma reduction work

    Hundreds of people have received stigma training