Whatsapp Group Discussion On Health Seeking Practices Veers Toward HIV Criminalization

It was a light moment that started with an Instagram picture of two men one sitting on top of the other.

The one down was reclined, resting on the elbows and shirtless in submission after a seemingly long wrestling match. The other on top was in jerseys, all sweaty, sitting on on top of the other's loins and using his weight to hold the other down.

It turned out that the man they were holding down was struggling forcefully with the health workers not to receive a mandatory Tetanus shot.

The anxiety of injections was mentioned and so were the positions of the men. Jokes ping ponged and insinuations suffused with sexual innuendoes were exchanged too.

The the moderator steered the discussion to health seeking practices such planning to visit a dental clinic, mental health units or scheduling a full medical check up.

It turned out that most only go to clinics when they are ill. Other than that they saw no utilitarian advantage of regular check ups.

And then, one other moderator asked something to do with HIV criminalization.

"I have just read something on HIV criminalization. Would you agree that a person who is living (the term used was infected) with HIV, knows it is deadly but who has unprotected sex with others is intentionally spreading HIV? Should such a person be condemned by law? Which law would it be? How would it read in simple language?"

The first answer:

"Yes, if the person does it intentionally to spread HIV and he knows it, he is guilty of the offense, I am not sure of the law but murder charges should be brought against such a person."

This same thought was followed by 25 others out of 35 who belonged to this Whatsapp group.

We should realize that many in this group already show that HIV criminalization has a  male/masculine skewed bias.

Members threw around the word guilty as if they were the very courts of law. 

Remember it is courts of law that pronounce the guilty or not guilty verdict. But, at this Whatsapp group we had constituted ourselves into a court. 

"The person is criminal but HIV is not. We should not criminalize HIV but the person that spreads it," went on one who had just joined the foray.

"HIV intended infection is punishable by law and is well stipulated in the Constitutions of many African countries," added another.

The moderator probed further for language and said that the crime should be HIV Voluntary Transmission. So, the law broken should be HIV Voluntary Transmission Law. That way, they agreed, it is specifically dealing with malicious act of spreading as well as neglect by professions from taking caution.

"What if both are sexually consenting and agree to have unprotected sex?"

This sparked more contributions on responsibility by both partners. But, it was made clear that the burden of protective conduct was placed on the one living with HIV.

"Responsible conduct is what binds all of us. It is like contamination containment. People with TB, wear face masks; food industry workers wash their hands every time they come out of a bathroom or washroom. So, one with HIV has to disclose to a sexual partner and ensure precautions are taken not to spread such as: carrying condoms, lubrication and other protective consumables."

"If one is exposed, then one should run to nearest clinic to be given PEP dose. If one is at risk, then one should enroll on PrEP and life goes on."

We say it so smoothly and we forget the human emotions. We don't factor in financial clout; family connections; adjustment feasibility to all best care options; and ability to fix a multitude of vulnerabilities (The four F's). The four F's being the HIV care grids. If the four F's are not applicable one is likely to be excluded from accessing or benefiting from optimal care.  

This discussion had very good input and veered into different scenarios around which we do not see much counselling literature. It appears as if Criminalization laws are affirming sexual intercourse between consenting married couples in a heterosexual normativity. Anything outside of this has been stigmatized and draped in demagoguery. 

Whatsapp Group Discussion Sparks Deeper Debate on The Contrasts Between What We Mean By Caring And What We Do about People Living With HIV

It is a group of about 35 members, it was initiated in 2014. Back then, they had 54 members and it was a vibrant one. 

Almost every two hours a new meme, theme or emoji about this or that was shared.

An occasional number featured showing a person who left the group.

And in came two or three others.

Soon, the moderators corralled in those of us who remained and showed us the purpose of the group.

Two or three were summarily dismissed from the group.

We even raised money at one occasion for a charitable goal I have forgotten. 

At another we helped trace three missing people.

We raised money for people living with HIV who did not have food and were about to be evicted from their houses.

HIV always brings to mind the words: exclusionary (contingent or facultative); inclusionary (obligatory inclusion); symbolic inclusion; and prescribed inclusion.  

The social structures with which we survive in Africa are such that for a person living with HIV has to have financial clout; come from a family which has connections; is at a condition where it is adjustment is feasible to all best care options; can fix a multitude of vulnerabilities (The four F's). The four F's are the HIV care grids.

Otherwise if the four F's are not applicable one starts dropping off the HIV care grid. Like a radio experiencing loss of signals.  This is when one is excluded from accessing optimal care.  

Society assumes individuals are supposed to take initiative and be part of its activities. Society is like a rope onto which we hold as we swing around. Letting go is uncalled for in this dangerous-sometimes-fun-game. It is expected of everyone to hold on to that rope tightly. 

Rarely do we have time to check on each other or for a person living with HIV. It is no wonder that persons living with HIV assume a survival mode and live on minimal scruples. This is including giving up many luxuries and isolating themselves when the applicability of the four F's we talked of is low.

But, it does not mean that theorising about why Africa still lets her Persons Living With HIV die forlornly is enough. We must go a step or two steps further.

We must agree to train peers in minimum care for others of the same peerage. A Task-Shifting of sorts. In an endemic climate of phobias, stigma and discrimination small support spaces once empowered with the four F's we talked of earlier will become the spaces of care in Africa. 1,000,000 or 2,000,000 million of these spaces will do a lot to reverse HIV.