In many places, one of the world's greatest health emergencies is spoken about in whispers. The mention of it can draw shame, ridicule, but most of all, fear.
"The stigma is mind blowing. Whether it's in the States or in Tanzania," said Alex Mathews, a volunteer manager for One Heart Source, which hosts HIV/AIDS volunteer projects in Tanzania.
The health field has always been popular for international volunteers, and HIV/AIDS education is becoming increasingly important in preventing the spread of the virus. But while it can be immensely rewarding to work in this area, volunteers are sometimes unprepared for the complex issues and attitudes surrounding HIV/AIDS once they go overseas.
"Whether you have experience previously or not, it can be difficult to hear the superstitions, misinformation and prejudices within the communities in which we work, and understand the cultural contexts of the disease on location," said Kaya Responsible Travel Director Heilwig Jones.
"The thing that amazes me about HIV/AIDS is that it's not solely a medicinal epidemic," Mathews said, explaining that HIV/AIDS is also wrapped up in many social and political issues. "How do you tackle all of these things at once?" That is what the world is trying to figure out. One of the United Nations' 8 Millennium Development Goals is to stop the spread of HIV by 2015.
Luckily, many HIV/AIDS programs now include more than just condom education, and address the bigger issues that put people at risk, such as gender inequality and poverty. International volunteers work with caring for AIDS patients, counseling HIV-positive people, leading education workshops, and caring for orphans of AIDS victims.
Stigma and fear
It's not clear how AIDS first developed, but ever since it was diagnosed in five men in Los Angeles in 1981, lack of information and myths in many communities has fueled intense discrimination. In many parts of the world, having HIV means being an outcast, in every sense of the word. Women are often shunned by their communities, forced to live away from society, because people are afraid to touch, or even be near, someone with HIV.
Jones said a lot of volunteers' work is to help reduce stigma in local communities, by showing that they are not afraid to be around someone who has the virus.
It may be as important to accompany a person to their blood test and hold their hand, as it is to be the doctor carrying out the test, when the taboo of the clinic scares [the patient's] family away.
An HIV/AIDS education group in Tanzania
A lot of the negativity stems from judgments that someone with HIV has behaved "irresponsibly," either by intravenous drug use or by sexual promiscuity. Fear of this shame is enough to prevent many people from getting tested or seeking treatment. Working to dispel these views, as well as to break down the myths, can be challenging.
Mathews remembers the first time she volunteered in Tanzania, when One Heart Source set up an HIV-testing site in a large, outdoor market. "It was a good opportunity to get people to get tested right there, who wouldn't have otherwise gotten tested, and within 15 minutes, know their status," she said. "Some of the responses were pretty sharp, like, 'Why do you come all the way from America to tell me I have HIV?'"
"There are myths and theories that the white people brought the virus to Africa, so there can be a trust issue oftentimes," she said. Some people believe that having sex with a virgin can cure HIV/AIDS. Another misconception is that HIV can be spread through coughing or just touching. That is why much of volunteer work is focused on raising awareness about the facts of HIV/AIDS, and showing support to the affected community, both of which can help reduce discrimination.
Who is the most vulnerable?
Women are the fastest-growing HIV/AIDS demographic, making up 60 percent of all new HIV infections. In many places, gender inequality and disempowerment make women more prone to contracting HIV.
"Poverty may force a woman to engage in risky behaviors when they have no other resources," wrote Bill Philbrick, Director of HIV/AIDS at CARE USA, an international organization dedicated to empowering women and reducing poverty. Women in poverty are more likely to have "transactional sex" in exchange for things like food or money, which increases their chances of catching the virus.
While many HIV/AIDS campaigns use the ABC approach (abstinence, be faithful, use condoms) to help educate women, this strategy has its limitations. Oftentimes, women understand the importance of using condoms, but they may be afraid to ask their partner to use one for fear of violence. In many societies, women are not socially equal, and don't have control over their sexual lives. Even if women are faithful, it doesn't mean their partners are. That is why many HIV/AIDS awareness programs are shifting their outreach to men, in order to reduce gender-based violence and empower women.
Unless you address these underlying causes for vulnerability and exposure risks associated with contracting HIV, you aren't really solving the problem.
- Philbrick said.
Street children are another vulnerable group, and a large part of One Heart Source's work. While volunteering in Arusha, Mathews became close with one 12-year-old boy, David, who had been living on the streets for about six months. "I saw him battling with the situation he was in, and it was hard," she said.
Her work with these children was basically "Education to help protect themselves...and just providing a safer environment for a few hours." From teaching English, to general health information, One Heart Source hopes to give children a strong foundation to build their lives. "Education, we believe, is the most effective way to empower others, and instill lasting change in perspective, lifestyle, and personal responsibility," Mathews said.
Preparing to volunteer
Mural in Mozambique depicting an HIV/AIDS testing center
Since volunteers work in emotionally sensitive atmospheres, many organizations look for compassion, flexibility, and open-mindedness. But no matter how passionate a volunteer is, Mathews said it can be frustrating if someone goes in with the mindset that he is going to change the world.
"Our aim is not to set out on a mission, deterring right for wrong, but rather enhance understanding through individual connection with others," Mathews said, emphasizing that change is made through small steps, and the relations volunteers make with the locals. "Inevitably, with connection, you're bound to impact each others' lives."
To help prepare, volunteers are recommended to read up on their destination's history and attitudes towards HIV/AIDS before departure. Avert.org is a great resource for country profiles and information. The Invisible Cure by Helen Epstein also provides remarkable insight into why HIV/AIDS is so prevalent in Sub-Saharan Africa, as well as the social and political factors behind the epidemic.
But no matter how much preparation volunteers undertake, Jones said it's important to be open to learning. "Come with open hearts, and try and understand that nothing changes overnight," she said. "Many volunteers want to fix things in four weeks, but they need to understand that what they are doing might light a spark in one individual who will pass it along, and that they are making a difference, even if they don't always see it."
What you need to know
HIV (the Human Immunodeficiency Virus) is a virus that destroys the immune system. A healthy person can have up to 1,200 immune, or CD4 cells, per drop of blood. If this cell count falls below 200, then the person is diagnosed with AIDS (Acquired Immune Deficiency Syndrome), and the body becomes susceptible to illnesses that a healthy person normally would be able to fight off. A person can live with HIV for years before AIDS symptoms appear. There is no cure or vaccine for HIV/AIDS.
A Global Epidemic*
33.3 million people are living with HIV/AIDS in the world.
More than two-thirds of the world's HIV/AIDS cases are in Sub-Saharan Africa.
Women are the most affected, making up more than half of the HIV/AIDS population.
The top 5 countries with percentage of people with HIV/AIDS are Swaziland, Lesotho, South Africa, Namibia, and Botswana.
*Source: UNAIDS Global Report 2010
Volunteer for HIV/AIDS education with these organizations:
IVHQ - Our HIV/AIDS volunteer program is aimed at giving care and support to the HIV infected and also creating awareness to vulnerable groups about the dangers of HIV/Aids through HIV/Aids outreach programs.
Kaya Responsible Travel - Volunteers work with HIV-positive children in Nepal or assist home-care workers in South Africa.
The Cornerstone Foundation - Belize is the most HIV/AIDS-impacted country in Central America. This local, non-profit organization located in San Ignacio runs projects for international volunteers.
Global Volunteer Network - This non-profit organization places volunteers in Africa, Asia, and the Americas, with HIV/AIDS focused projects in Kenya and Uganda. Volunteer support is provided at every stage of the project, which may last two weeks to six months.
Cross-Cultural Solutions - This company has HIV/AIDS projects in Africa and the Americas, where volunteers provide medical assistance, day-to-day support, prevention services, and community outreach and education.
Have you volunteered with HIV/AIDS? Share your experience below!