POTOMAC, Maryland — In an anonymous testimony to the Tunisian Association to Combat Sexually Transmitted Diseases and AIDS, a woman recounted her story: after her husband succumbed to AIDS, his family expelled the woman from the house she had shared with her late husband. She and her children were left to the streets with nothing, for she was mistakenly accused of causing her husband’s death.
Tunisia, with a population of approximately 10.8 million people, doesn’t suffer from an AIDS epidemic. In 2012, only 2,300 Tunisians suffered from AIDS. But the HIV-caused disease is becoming more prevalent.
There are select groups within which rates of AIDS are disproportionately high. 13 percent of men who have sex with other men have contracted AIDS. 2.7 percent of intravenous drug users and 0.6 percent of female sex workers are also afflicted by the syndrome.
The government has been quick to respond to these rising numbers, offering condoms, lubricants and single-use syringes — HIV-afflicted citizens also have access to free treatment, and the government has headed many awareness projects, targeting female sex workers, prisoners, intravenous drug users and homosexual men.
Public perception and the stigmas associated with AIDS, however, has prevented many AIDS victims from pursuing the equal access to healthcare that Tunisia has proudly cemented into law.
Moreover, Article 230 of the country’s penal code punishes same-sex relations with up to three years in prison. Similarly, drug use can lead to five years in prison. Sex workers can face two years of imprisonment, although enforcement of this particular law has been largely ignored.
Because many of the sufferers of AIDS in Tunisia belong to groups that are criminalized, many fear imprisonment or unfair treatment by authorities.
This phenomenon isn’t unique to Tunisia however.
In Ghana, Jones Blantari — chief superintendent of the anti-narcotics department — hopes to overcome these fears by carrying with him at all times a bag of condoms.
Culturally, condoms have been equated with immorality and religious heresy, but Blantari wants to remove religion and morals from the picture altogether. To him, it is a matter of common sense. If a Catholic policeman can carry condoms, so can anyone else. At least, that is the message Blantari wishes to convey.
Ghanaian police — aware of the difficulties sex workers and drug users face in seeking treatment for AIDS — have accordingly relaxed their enforcement policies to avoid isolating groups already stigmatized by their condition.
In the United States, this thought is echoed by Jim Pugel, former chief of the police department of Seattle. In the city, he says “police officers are involved in ignoring the letter of law which says you have to arrest people who have drugs.”
But sex workers in Kenya aren’t shown such restraint.
1.6 million people in Kenya live with HIV, more than half of whom are women. As such, clinics dot the country, offering emergency antiretrovirals and post-exposure prophylaxis (Pep) treatments.
Pep treatments, which combat HIV infection if taken within 72 hours of exposure, have virtually replaced the use of condoms for female sex workers. Normally, clients must use protection, but some pay extra to void the requirement. Since money is hard to come by, many prostitutes oblige the request.
To gain access to these treatments and medications, it is not uncommon for these women to lie to medical providers. Otherwise, sex workers are denied treatment and shooed away. Clinic staffers are simply not trained to deal with the complex situation that is presented by a patient who engages in criminal activity.
Dr. Rachel Baggaley, who works for the World Health Organisation’s HIV team, believes pre-exposure prophylaxis (Prep) should replace Pep treatment. Taken before — as opposed to after — exposure to HIV, Prep treatment better fights infection. It also involves fewer toxins and is therefore less taxing on one’s body.
But as this treatment is new and yet to be proven beyond small-scale trials, in countries like Africa — or Tunisia and Ghana for that matter — political leadership must foster more sympathetic attitudes toward AIDS sufferers, regardless of who they are.
– Shehrose Mian