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World Aids Day, 1 December - Fight the virus and the stigma

When it comes to HIVAids, education is key. The battle is not just against the disease but discrimination, too. James Williams reports

When it comes to HIVAids, education is key. The battle is not just against the disease but discrimination, too. James Williams reports

When 18-year-old Nokhwezi Hoboyi's first child died at the age of just six months from whooping cough, the young mother was devastated by the tragedy. In 2002, her second baby was diagnosed with pneumonia and when the child was just four months old her grief-stricken mother gave permission for her life-support machine to be switched off.

Hoboyi had been told by doctors near her home in Africa that she had a "rare illness". But it was not until many years later that she learned the name of the deadly infection that she had passed to her infants and that would come to terrify the world: human immunodeficiency virus, or HIV.

We now know that HIV attacks the immune system and destroys the white blood cells that should protect us from disease. And with the immune system compromised, any illness - even one our body would normally be able to fight off unaided - can become a killer. When HIV has weakened the immune system severely, sufferers can be diagnosed with acquired immunodeficiency syndrome, or Aids.

In the 1980s the realisation hit that there was a new, deadly disease, and it created global panic. In that decade, and the next, Aids sufferers and those who were HIV positive endured not only the disease - then a veritable death sentence - but also discrimination and stigmatisation.

In many Western countries, HIV positive people were shunned even by their families, and subjected to abuse and maltreatment, as myths grew about how easily the virus could be spread.

Today, although HIVAids is nowhere near eradicated or cured, people with HIV can, in countries where medication is available, expect near normal lifespans. But while the cocktail of drugs that transformed Aids from a killer to a chronic disease has been available since 1996, ensuring that all sufferers have access to them has not always been easy.

Now the World Health Organisation (WHO) has produced a book, Bugs, Drugs and Smoke: stories from public health, about the battle it has fought against Aids and other life-threatening diseases since it was set up in 1948. It explains in clear, non-technical terms how mankind developed techniques to protect the health of communities.

The book also describes the "wall of silence" mounted by governments in some developing countries and how any mention of the disease by visiting health workers and Aids campaigners could result in punishment, even deportation. Fear was the main issue. Sufferers were left alone to die. Even medical staff, unaware of precisely how the disease was spread, did not want to treat anyone they suspected of being infected.

One thing HIVAids wasn't, even in the late 1990s, was a "rare illness". It was a growing pandemic that at one stage appeared overwhelming. But the tide appears to have turned. In July this year Dr Margaret Chan, director general of WHO, told an international Aids conference in Washington DC: "Now, finally, we have gained the upper hand. We are in a position to outsmart HIV, turn the epidemic around and celebrate its end. The modern world has never known a virus quite like this one, with its long incubation period, its ability to destroy the body's defence system, its defiance of monumental efforts to develop a vaccine or definitive cure, and the multiple factors that make it so stubbornly persistent."

A worldwide strategy, developed by WHO, is on track to supply many more HIV victims with antiretroviral drugs. At the Washington conference Dr Gottfried Hirnschall, director of WHO's HIV department, confirmed the organisation's optimism in achieving the target of delivering antiretroviral treatment to 15 million people by 2015.

Education can bring hope

Controlling and eliminating the stigma in some countries may take a little longer. Even today, many people delay or avoid being tested for HIV for fear of the discrimination that may follow, from withholding treatment in some countries to dismissal from work. In Botswana, for example, a 2006 survey of patients receiving antiretroviral therapy found that 40 per cent delayed being tested for HIV, mostly due to stigma.

Last year, US President Barack Obama was quoted as saying: "More awareness is needed so that no one with HIVAids is stigmatised or discriminated against." And this year, at the Washington conference, WHO's Dr Chan said: "The fight has been not just against a virus but also against stigma and discrimination."

Education is, of course, the key. Bugs, Drugs and Smoke is an invaluable tool to help teachers not only convey the reality of 20th and 21st-century diseases with clarity, but perhaps inspire young people who are considering a career in public health.

For Hoboyi, the tragedy of losing two children to HIVAids cannot be overstated. But her story is also one of survival and hope. Once she learned what her "rare illness" really was, she became a committed Aids activist. With access to antiretroviral drugs, something she did not have in the late 1990s, she was able to conceive again. In 2007 she gave birth to a son, Qhayiya. He was HIV negative. And Hoboyi continues to spread the truth about how to stay safe from Aids in her new role as an educator.

James Williams is a lecturer in science education at the

University of Sussex's School of Education and Social Work. For more information about Bugs, Drugs and Smoke, visit: bitly.comKxBv3m


Key stage 1: World Aids Day

A simple PowerPoint from foxedup80 raises awareness of HIV and Aids. bit.lytesWorldAidsDay

Key stage 2: Kishe's story

Pupils can find out how HIV affects communities with HamiltonTrust's resource pack focusing on an orphan's story. bit.lytesKishe

Key stage 3: Understand Aids

Explain the differences between HIV and Aids using a presentation by leighbee23.


Key stage 4: How much do you know?

Test your pupils' knowledge of HIV and Aids with a quiz shared by The b. Awareness posters are included.


Key stage 5: HIV briefing

Explain the details of the virus using this booklet from Society for General Microbiology.


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