Being positive about HIV
Tuberi Cati has become synonymous with HIV and AIDS, in the most positive way. Testimony perhaps of surviving with HIV for 16 years now but more so, for her passion and dedication as an advocate for a more holistic and positive response to the community of people living with HIV.
The road to where she is today has been fraught with challenges and personal sacrifices for Cati who believes she contracted the human immunodeficiency virus (HIV) from her first husband. She learned of her status when she was all of 22.
"I am so glad I knew my status because it has changed me fundamentally for the better," Cati said, after the Pacific United Nations family celebrated World AIDS Day (WAD) on December 1. "There is no fear in knowing your status so I always emphasise this first step of knowing."
Cati reckons Fiji "is a lot more receptive now". As her advocacy work took her to high-level meetings, the space in which she now recounted her story made her realise she needed more than just anecdotes to battle confidently and effectively for her constituency.
A year after disclosing her status, Cati met Emosi Ratini, also living with HIV, in 2007. The couple now have three children who have all tested negative, thanks to critical treatment to prevent and/or eliminate mother to child transmission.
Cati's eyes light up when discussing her journey through university. She was a private student but it has all been worth it, she says with a smile. Not only has the experience stimulated her intellectually but Cati now feels the empowering oomph a tertiary qualification has lent her anecdotes and/or experiences.
Cati now sits at the UNAIDS Pacific office in Suva (Fiji) as the country co-ordinator of the second round of People Living with HIV Stigma Index Project, a research project that will measure the impact of HIV-related stigma and discrimination in Fiji. It is a collaboration between UNAIDS, ICW, GNP+, FJN+ and the Fiji Ministry of Health and Medical Services.
Findings generated from the project will strengthen advocacy for people like Cati who can now provide evidence-based arguments for action that will contribute to a stigma and discrimination-free environment for people living with HIV.
The stigma index tool was developed by people living with HIV, for people living with HIV. Data generated will be comparable internationally in relation to HIV-related stigma and discrimination. The advocacy borne out of the project will therefore be relevant and useful at the local level while contributing to a better global understanding of HIV-related stigma and discrimination.
"Whether stigma and discrimination has improved or worsened is something that this study would like to explore," Cati said. "Self-stigma has been identified as one of the barriers to the greater involvement of people living with HIV and is also a cause and consequence of family rejection, tokenistic attitude towards people living with HIV, and violence towards women and other groups living with the virus.
"Within Fiji, it will support capacity-building and up-skilling of people working in related fields including the identification of key issues for advocacy. We have to effectively address stigma or we will never achieve zero discrimination, zero new infections and zero AIDS-related deaths."
Increasingly, HIV impacts adolescent girls and young women who are vulnerable to violence, child marriage, who lack sexual and reproductive health information, who are not in a position to negotiate safe sex, and who have no access to sexual and reproductive health services including condoms, HIV/STI testing and counselling, and treatment.
Globally every year, there are 380,000 new HIV infections among girls and young women aged 10-24, constituting almost 60 per cent of all new HIV infections though generally-speaking, new HIV infections have been reduced by 35 per cent since 2000 and AIDS-related deaths have been reduced by 42 per cent since the peak in 2004.
United Nations Development program representative and UN resident co-ordinator Osnat Lubrani reinforced the global effort of fast-tracking the response to end AIDS. Already 15 million people are accessing life-saving HIV treatment.
"Here in Fiji, although new cases are reported each year, the UN is still committed to work with our partners in ensuring that programs and services are in place so that we are part of the global movement to fast track the response to AIDS," Ms Lubrani said.
Addressing restrictive social norms that prevent women and girls from accessing sexual and reproductive health information and services and owning their sexual health is crucial. Fifteen per cent of all women living with HIV are aged 15-24.
"Clearly, our responses to HIV must address the needs of adolescent girls. Concerted efforts are needed to change these gender norms and to make communities safe and supportive for young women and girls," Dr Laurent Zessler, United Nations Population Fund (UNFPA) Pacific sub-regional office director and representative, said.
"Prevention champions play an important role - individuals who speak out and encourage communities to reduce their risk, take control and stop further transmission.
"People living with HIV and key populations at risk also need to be empowered to help end stigma, discrimination and violence, advocate for removal of punitive laws, and increase access to justice and sexual and reproductive health services."
UNFPA supports greater investment in integrated HIV and sexual and reproductive health services, including for the elimination of mother-to-child transmission, and progress is being made. The organisation continues to support governments and community organisations strengthen integrated maternal and child health services, as well as community-led responses.
UNFPA supports the human rights of key populations to live free of violence, stigma and discrimination and to freely access services in order to protect their health, the health of their sexual partners and dependents, and ultimately, of the whole community.
The Sustainable Development Goals call on us to leave no one behind, and that includes people living with HIV. We help ourselves when we all work towards a stigma-free community, for you couldn't ask for a more enabling environment for fast-tracking the response to end AIDS by 2030.