End HIV stigma to reduce mental  health challenges

May 10 to May 15 is mental health awareness week and Uganda joins the rest of the world to reflect on the impact of mental illnesses on the lives of her citizens and economy at large.

The New Vision earlier this week reported an increase in the number of mental health cases in the country, currently at 14 million people. On May 12, it was again reported that researchers had detected drug-resistant HIV.

While Members of Parliament this past week requested the government to increase the funds for mental health in the Ministry of Health budget, it is high time we thought about finding personal level solutions to this problem, and this is the complete end of HIV related stigma.

Uganda Aids Commission Director-General, Dr Nelson Musoba, while speaking at the Interest 2022 Conference associated this with reasons including stigma. 

He said, “Injectable Antiretroviral Therapy (ART) will address the problem of stigma associated with daily oral pills and this will improve drug adherence hence minimising drug resistance.”

According to the 2005 Social Psychology of stigma: Annual Review of Psychology report by NIH National Library of Medicine, stigma directly affects the stigmatised via mechanisms of discrimination, expectancy confirmation, and automatic stereotype activation, and indirectly via threats to personal and social identity.

The report explains that identity threat creates involuntary stress responses, affecting one’s social identity thereby upsetting important outcomes such as self-esteem, academic achievement, and health.

People living with HIV (PLWHIV) are at high risk of suffering from mental health because of stigma and the tough decisions associated with the situation.

Uganda has over 1.4 million people living with HIV/Aids and if these succumb to stigma, the number of mental illnesses in Uganda will soar.

Stigmatising PLHIV may cause reduction in the number of people willing to take HIV tests, yet if someone does not know their serostatus, they can easily transmit the virus.

It gets worse for other groups of PLWHIV who are gay and or injecting drugs as they face second degree stigma as they are already marginalised by the society.

There are many PLHIV who fail to adhere to their drugs in prescribed hours because they fear what others will say about them. Some of these are children in school. Records from Uganda AIDS Commission for 2020 indicate that over 98,000 children live with HIV, 4,300 of whom are between 0-14 years.

 I am already contemplating on either adding or subtracting this number to the already 14 million Ugandans suffering from mental health challenges.

Tedopista Nabukwasi, a community worker at Reach Out Mbuya Community Health Initiative, says that sometimes they receive cases of mental health among their clients, whom they refer to Butabika hospital for treatment. She adds that assessments done on some of these clients reveal inclination to stigma from those around them, thereby contributing to self-stigma.

I therefore call upon members of society, the government and other bodies in the struggle against HIV to think hard and seriously implement behaviour change interventions aimed at ending stigma, or else the pandemic is here to stay. Let us extend love, respect and trust to PLHIV to curb HIV and mental health in Uganda. #endHIVstigma

Ms Annet Nakibuuka is a public relations officer at Reach Out Mbuya Community Health Initiative