VIH et SIDA
Reaching the poorest, most marginalized and least served has been at the core of successful HIV and AIDS programming. That imperative is even greater in an era of static resources and ever more complex competing priorities.
The elimination of new HIV infections and AIDS-related deaths in children is possible, but it will require vision, leadership, system-wide improvements in health-care delivery and support for linkages to families and communities, as well as deep-seated social change and continued implementation of best practices.
Integrating interventions into existing systems without losing the capacity to address the specific needs of children affected by AIDS is a challenge in all four of the ‘Unite for Children, Unite against AIDS’ priority areas: preventing mother-to-child transmission; providing paediatric care and treatment; preventing infection among adolescents and young people; and protecting and supporting children affected by HIV and AIDS.
Why partner with religious communities to address HIV?
“We have a unique presence and reach within communities. We have unique structures and programmes that are already in place. We are available. We are reliable. And we are sustainable. We were there long before AIDS came and we will still be there when AIDS goes away.” (Canon Gideon Byamugisha)
The foundational principles of all the major faith traditions – love, compassion, respect for the dignity of all persons and charity for the less fortunate – ground the work of religious communities in the face of HIV. Religious leaders are the moral compass of faith communities and can foster inclusive and compassionate responses to those affected by the disease in their midst.
Religious communities are already at the forefront of efforts to prevent and respond to the pandemic, particularly at the community level. The financial contribution “of faith-based volunteers throughout Africa to address HIV was estimated to be worth US$5 billion per annum in 2006, an amount similar in magnitude to the total funding provided for the HIV response by all bilateral and multilateral agencies”. Focused at the community level, religious organizations can quickly respond and adapt to changing needs. Community members report that what they most value about religious actors’ provision of HIV services is their capacity to deliver spiritual and psychosocial care, even above the more tangible medical services.
Recognizing the significant role that religious communities are playing in the provision of a range of HIV-related services, while acknowledging areas in which they could be supported to respond more effectively, has led to the development of the Partnership with Faith-based Organizations: UNAIDS strategic framework. The purpose of the framework is to encourage stronger collaboration between the Joint United Nations Programme on HIV/AIDS (UNAIDS), partners such as UNICEF and FBOs to achieve universal access to HIV prevention, treatment, care and support, which includes the integration of FBOs in comprehensive national AIDS responses.
For all that religious communities do to uplift people affected by HIV and AIDS, there are situations in which the stigma attached to living with HIV can lead to a culture of silence in religious communities, often fostered by religious beliefs that sustain the shame associated with the illness and instil fear. This silence and fear holds many back from seeking needed treatment and emotional support. Additionally, many people at highest risk for contracting HIV – such as sex workers, men who have sex with men and people who inject drugs – engage in behaviour that may be considered taboo. Leaders in religious communities can be instrumental in challenging attitudes and confronting stigma, shame and taboo subjects by focusing on the values of dignity, respect and compassion their faiths share.
Women of faith play an important role in both care giving to families affected by AIDS and HIV prevention efforts. While they may not often be visible in the formal leadership structures of religious communities, they are key actors in efforts to deal with the pandemic’s effects and related issues such as reproductive health and sexual and gender-based violence. It is important to make efforts to seek them out and support their substantial leadership.
There will, inevitably, be areas of work in which there is disagreement about particular approaches. For example, condom distribution as an HIV-prevention activity may not be supported by some religious communities. Yet it may be possible to disagree on certain aspects and still work together on areas of common agreement such as, for example, addressing stigma and discrimination against children affected by HIV. The UNAIDS framework outlines the roles and responsibilities of United Nations and FBO partners in the AIDS response and can be an important starting point to negotiate the more controversial aspects of HIV and AIDS interventions.
What can religious communities do to address HIV and AIDS?
In all of the following areas, religious communities can refer to sacred texts, scripture and scholarly works to promote compassion, healing and actions that respect the dignity and sanctity of all life. Depending on the epidemiological setting, they can also mobilize their significant human resources – including volunteers, women and youth groups – for large-scale or focused community education and advocacy.
Preventing mother-to-child transmission (PMTCT) of HIV
- Encourage early infant diagnosis when parents are HIV-positive.
- Support access and linkages to health facilities and services.
- Strengthen PMTCT services- in line with national policies and protocols- in religiously affiliated hospitals and medical centres, particularly in rural areas, and ensure coordination with national health systems addressing HIV prevention and treatment of AIDS-related illnesses and/or anti-retroviral therapy for those who need it.
Providing paediatric treatment and care
- Deliver care, treatment and supportive counselling, particularly in the most rural and disenfranchised communities. This includes palliative and hospice care for end-of-life support.
- Ensure coordination with national health systems and adhere to national plans and protocols on HIV prevention and AIDS-related treatment.
- Direct charitable resources to evidence-informed prevention and care activities, including early infant diagnosis and follow up.
- Train and educate caregivers and family members of persons living with HIV or who have AIDS-related illnesses by providing information relevant to their faith.
Preventing infection among adolescents and young people
- Disseminate and discuss teachings that promote safe and healthy behaviours and practices to prevent sexual and non-sexual HIV infections and transmissions.
- Provide non-judgmental support to populations most at risk of HIV to enable greater access to HIV prevention, treatment, care and support services.
Protecting and supporting children affected by AIDS
- Use the moral influence of religious leaders to challenge stigma and discrimination, and foster dialogue within their communities to change attitudes of rejection of persons living with HIV or AIDS to acceptance and support.
- Join broader advocacy efforts, including linking to national systems, beyond their respective religious communities to change policy, legislation and general perceptions.
- Direct charitable (cash and in-kind) resources to family-based care and support activities, notably those that promote social protection strategies and policies, are AIDS sensitive and address the needs of these and other vulnerable populations.
- Facilitate access to health and social services and promote the protection and education of the children of those living with HIV and AIDS.
- Train and educate caregivers and family members of persons living with HIV and AIDS with information relevant to their faith.
- Provide spiritual guidance to enhance individual and community acceptance of children affected by AIDS.