In this post, Chris Carter, a final-year medical student at the University of Birmingham, continues his series of blogs from a hospital in Botswana …
Outside of the hospital, HIV/AIDS appears to have become fairly taboo amongst the locals. On more than one occasion, I have been party to conversations which put down those living with HIV/AIDS (to put it mildly). Statements to the effect of ‘who would want to marry someone with HIV/AIDS?’ are far more common than one might expect, especially amongst those at the higher end of the socio-economic scale.
It seems that the relationship between education and transmission is having a widespread effort across Botswana, whereby those identified as HIV positive are deemed to be less well educated and of a lower social class. Doctors are perhaps a culprit here. Able to see the epidemic from both sides of the coin, they can easily recognise where a lack of education has led to transmission and hence often perpetuate this link.
Speaking to the healthcare workers, you would form an impression that education is at the forefront of Botswana’s policies in tackling HIV/AIDS. I have heard a lot regarding the introduction of school teaching on the subject and increased awareness amongst local youth groups. For me though, it appears as if Botswana has almost given up on its adult population, making up by far the majority of those living with HIV. Whilst they are able to receive the medication they require, they are not being targeted for education about any aspect of their infection.
Therefore, many patients are unaware, for example, of the importance of adherence to medication and the precautions required to prevent the transmission of the infection. Telling someone these things once is not enough. Attitudes need to change on both sides, such that patients take more responsibility for their actions and doctors are equally responsible for the care of their patients. Prevention is of course imperative in the fight against HIV/AIDS long term, but more can and should be done to help those living with the infection in the here and now!