Misir’s book on HIV/AIDS stigma and knowledge attacks problem at its root

AIDS is a global epidemic and the resulting stigma is a global problem, is the theme of University of Guyana Pro-Chancellor Professor Prem Misir’s new book ‘HIV & AIDS Knowledge and Stigma in Guyana’. While living and working in New York as a former associate public health epidemiologist with the Bureau of HIV and AIDS Prevention and Control, New York City Department of Health and Mental Hygiene, Professor Misir found that people living with HIV and AIDS experienced stigma and discrimination, especially the minorities. Realising the huge impact of stigma on people with HIV in the developed world and its unparalleled damage on poor and developing countries, he turned an analytical eye to the degree of HIV and AIDS knowledge among young people, and research on ‘HIV and AIDS Knowledge and Stigma in Guyana’ was born.

PREM MISIR

The book published by the University of West Indies Press, was described by distinguished reviewers as a timely and relevant work, and it is hard to disagree with this view. The reason being, Misir decided to get at the root of the problem targeting young people who were on the brink of or already becoming sexually active, who were most likely to engage in risky behaviours and who were most likely to embrace myths about HIV and AIDS.
In the foreword to the book, Head of School of Public Health, University of Oxford, Dr. Premila Webster notes that HIV/AIDS is the leading cause of death among the 20-49 age group in Guyana. Several of those with HIV or AIDS in their 20s could have contracted the infection in their adolescence. She says that limited understanding of the myths and misconceptions of HIV and AIDs in the group hampers the implementation of policies related to prevention, education and awareness.
Today more than two million young people aged 10-19 years are living with HIV. On the occasion of World AIDS Day 2013 (December 1), The World Health Organisation (WHO) highlighted the urgent need for better tailored HIV services for adolescents.
Thus, ‘HIV and AIDS Knowledge and Stigma in Guyana’ is surely a book for these times, as a case in point – WHO only two months ago issued – the first-ever guidelines addressing the specific needs of adolescents living with HIV: “HIV and adolescents: Guidance for HIV testing and counselling and care for adolescents living with HIV, which recommended that governments review their policies on consent to services in order to make it easier for adolescents to obtain HIV testing without consent from their parents. The publication also provides guidance on how health services can improve the quality of care and social support for adolescents living with HIV.
‘HIV and AIDS Knowledge and Stigma in Guyana’, is a cross sectional study that used a purposive sample of 379 high school students of different religious and racial backgrounds from 15 urban and rural high schools in Guyana and assessed their HIV and AIDS knowledge and stigma related attitudes, and the relationship among gender, age, religion, race/ethnicity and HIV and AIDS knowledge. The students were from the 4th an 5th forms (grades 10 and 11).
The study attempted to answer the research questions: What is the status of HIV and AIDS knowledge and stigma-related attitudes and perceptions among high school students?; What are the differences in HIV and AIDS knowledge and stigma-related attitudes by gender, age, religious groups and ethnic groups?; Is there an overall relationship between HIV and AIDS knowledge and stigma-related attitudes?, and Is there a relationship between non-normative aspects of HIV and AIDS knowledge and stigma-related attitudes?
Misir’s findings as chronicled in the book reveal an overall moderate level of HIV and AIDS knowledge, an understanding of the modes of HIV transmission and recognition of the symptoms of HIV and AIDS. The study also showed that nearly half of the students held that a blood donor was at risk of contracting HIV; and about one fifth of them supported myths and misconceptions about HIV and AIDS.
As the back cover of the book notes: “There was no statistically significant difference in the knowledge scores of male and female students. Knowledge scores, nevertheless, differed significantly between the 13 to 15 and 16 to 18 age groups, and among the religious and ethnic groups. Stigma-related attitude scores did not differ significantly for gender and age, but differed significantly for religion and ethnicity among students. The study showed fissures in HIV and AIDS knowledge and substantial stigma related attitudes.”

Misir noted in a recent interview that: “You can have all the knowledge of HIV, yet discriminate against persons with HIV.” Continuing, he even noted that “Knowledge is not panache to solve problems.”
So in the book Misir has distinguished between the two types of HIV and AIDS knowledge, the more obvious ‘clinical knowledge’ but the more often less taken into consideration “non –normative knowledge’.
The author indicated that he began to realise the negative impact of myths and misconceptions about HIV and AIDS on high risk sexual behaviour in the course of the research process. He also proclaimed that “Many prevention messages on stigma focus on compliance with conventional HIV and AIDS knowledge to the exclusion of misconceptions and myths and thereby reducing the potency of the prevention message.” However, Misir affirmed that “prevention messages must incorporate conventional HIV and AIDS knowledge as well as misconceptions and myths about the disease.”
Finally, Misir’s perspective of the findings emanating from this study is that “it will allow health professionals and educators throughout the region to review the educational needs of high school students when it comes to understanding the basics of HIV and AIDS. He continued that “The findings will also enable health professionals and educators to appraise the sufficiency of students’ knowledge of HIV and AIDS, how much knowledge of HIV and AIDS influence students’ assimilation and application of stigma toward people living with HIV (PLHA).”
Professor Prem Misir is the Pro-Chancellor of the University of Guyana and Professor in Public Health at the University of Central Lancashire in England. In addition, he is with the Faculty of Health Sciences University of Guyana, teaching Research Methodology and Biostatistics and was a visiting Professor at the University of West Indies, St. Augustine and Anton de Kom University of Suriname.
His many publications include ‘Cultural Identity and Creolisation in National Unity’, ‘The Multi-ethnic Caribbean and Leader Behaviour’ and ‘The Compliance Structure in Education: A Sociological Study of Ideology and Social Change in Guyana’.
HIV &AIDS Knowledge and Stigma in Guyana is available at amazon.com, uwipress.com and Austin’s book store.