David S. Mukasa

When I started my life with HIV in 1989, there was almost nothing more to conceal about my life. The only alternative left to me was to come out and face HIV infection, stigma, and discrimination squarely, using what I had gone through as a means of helping others. What else could I do when I "knew" almost everyone in my community had come to know about my plight! I had been bed-ridden for more than a year and until I finished my TB therapy, there was no hope for me; at least that's what everybody believed then. I thus made a personal refusal and determination not to succumb to stigma.

As much as there is social stigma that we people living with HIV/AIDS ("PLWHA") suffer from society, there is also self-stigma that comes from within. These two are intertwined, but self-stigma is more difficult to recognize and to deal with. In fighting self-stigma, the major strategies which have helped me and which could be so important for other PLWHA include receiving ongoing, high-quality counseling, fellowship with other PLWHA, or the encouraging support of interactive self-help groups. These have been a major factor in empowering me to openness and, hopefully, they could be for many others who are facing anxiety, fear, stress, or other negative feelings and attitudes due to HIV infection. But the most important thought for my peace of mind and regaining my self-esteem was to accept myself rather than fight what was. I also thank my parents, brothers, and sisters who accepted me from day one (although one of my sisters vehemently protested my going public because it "would bring shame to the whole family."). My children have, however, reported incidents of stigma and discrimination at school and in our neighborhood because of our openness-my wife's and mine.

I had to become a survivor. I had to move away from all negative feelings and tendencies if I was to lead a fairly good and free life. I made a conscious effort to move away from ignorance, fear, stigma, and discrimination, but, above all, I first dealt with the self-stigma that was so apparent inside me. I had to become master of my life, be in charge. A major setback was being dismissed from my work as a teacher because of my HIV-positive status.

In dealing with self-stigma, we must tune the mind to cope. I became aware of my own healing potential by confronting my HIV status honestly. "Healing" is a creative act calling for all the hard work and dedication needed for other forms of creativity. To overcome stigma, be it internal or external, ultimately depends upon an individual's beliefs and lifestyle. Getting well (or at least better) is not the only goal if you are to overcome stigma and discrimination; even more important is learning to live without fear, to be at peace with life, and ultimately to be in harmony with other people. Hope came about largely as a result of my confidence and trust in those who exchanged with me, who consoled me with their compassion, acceptance, availability, empathy, and willingness to share information.

A sense of humor can be an enormous asset in dealing with stigma and discrimination, too. Allowing for laughter, though others may think you are denying the reality, drives many around you to check their behaviors toward you and without knowing it, you provide some kind of solution to stigma and discrimination. The way we receive particular prevention, care, or support messages also influences greatly the extent and magnitude of how we experience self-stigma. It sometimes becomes so deep rooted that we can become selective in how we respond.

David S. Mukasa
Uganda Red Cross Society
Email: davidsmuk86@yahoo.com