From the PLHIVs point of view

PLHIV IS ONE OF THE MANY KINDS OF ABBREVIATIONS that has sailed into public prominence as short-hand references to describe and conceptualise issues related to HIV and AIDS since the crisis became a pandemic in many Pacific Island countries. To begin with, the terms HIV and AIDS are already abbreviated symbols each of which is blown to the shape and sound of a single noun. Another common example of this kind of short-cut phrases is the popular alphabetised ABC (Abstinance; Be faithful or Believe in God and the use of Condoms) prescribed and publicly promoted as the best methods to avoid HIV infection.

I do not know where this penchant towards abbreviation comes from but perhaps we can account for it by the sheer need to simplify the intrusive technicalisation of scientific language in common parlance. Abbreviation keeps a coded language private and a public language intelligible but in both languages it creates its specialised set of lexicons as do all intelligible languages. Words and meanings migrate and populate public discourse and historical circumstances precipitate into verbal residues of specialised lexicons which can sometimes run dry with meaning much like our contemporary experience of the credit crunch. 

Interesting as the case maybe with the relativisation of meaning, what comes along with this conceptual scheme of abbreviation is a technique of classification that assigns particular definitions to a whole class of persons. Abbreviation precedes classification because it names and establishes boundaries around its definitions while classification sorts out the names into different types so that it could get people into the business of rational organisation, control and management. If abbreviation creates a subject through its power of naming, classification exercises the same to its desired objectives.

We are concern here with one such abbreviation called PLHIV which stands for Persons Living with HIV. I do not know if its definition also extend to include Persons Living with AIDS, and if not, this may has its own abbreviated form such as PLAIDS. According to a recent Post Courier news article (03/11/08), Port Moresby, is witnessing for the first time a Conference that involves the participation of 150 people living with HIV. This phase-setting event is funded by the AusAID and it brings in people not only from Papua New Guinea but also from places as far as the Cook Islands, Aboriginal and Torres Strait Islanders and the nearby Solomon Islands. Igat Hope, a popular non-government organisation in PNG that deals with HIV and AIDS issues, appears to have played a leading role in the organisation of this Conference.

The Conference was opened by Anglimp-South Waghi MP, Hon. Jamie Maxtone-Graham, who chairs the Special Parliamentary Committe on HIV/AIDS in Papua New Guinea. Co-ordinator of Igat Hope, Mrs. Annie Mac Pherson, made the following remarks when the Conference was opened. “Its fantastic! For the first time we are bringing the PLHIVs to develop a way forward on how they can work with each other in the national HIV response”. The Minister for Community Development in PNG, Dame Carol Kidu, was also also at this event and she was encouraged by witnessing the presence of many PLHIVs. She noted that, for some years in Papua New Guinea,

“it was difficult for such people to get together but this meeting was finally taking place because of the courage of a few people who revealed their HIV status in those years when there was still a lot of fear in doing so”.

This news of seeing that PLHIVs coming out in the open is very encouraging and should open up new avenues for thinking about the best possible strategies to respond to the HIV and AIDS pandemic that has now put all Pacific Island countries under a very serious threat. While the Conference is intended to cover issues such as universal access to treatment, leadership and the support for PLHIVS, I wonder if there is any hope of finding a new ethical direction when we listen to the concerns and experiences of PLHIVs. The comments from the Minister, Dame Carol Kidu, can be read in a different light.

The courage of some PLHIVs has daringly confronted the fear of revealing their status. When this fear is defeated, a new ray of hope and optism comes in. If more and more people reveal their status, sooner or latter, we might have the chance of fighting and naturalising stigma and prejudice associated with HIV and AIDS. Perhaps part of the counselling that PLHIVs sometimes receive once their status is established must be geared towards preparing them to have the courage to tell other people about their status.

Ultimately, I am hoping to see if this courage in revelation might give us a new ethical framework to manage our responses to the pandemic. What kind of ethical insight can be gained from learning from the experiences of taking on the point of view of the PLHIVs? The courage of revelation exposes the delicate nature of maintaining medical privacy relating to confidential health information. Because the courage of revelation works on individual choice and desire to reveal, it actually preserves the ethics of medical privacy by allowing PHLIVs to speak about their status with a spirit of care and concern about the health and safety of the public at large. 

This might therefore provide an alternative moral leeway out of the burdens imposed on our national responses to the pandemic by the ethics of maintaining patient confidentiality. If abbreviation keeps a coded language private and a public language intelligible, the courage of revelation appears to reveal two faces of privacy: one makes privacy an ethical burden to preserve and the other makes revelation a desirable and ethical responsibility to undertake. The courage of revelation brings visibility and responsibility into a single universe of ethical choice and moral action. It seems to me that the doom and gloom the HIV and AIDS pandemic offer for Pacific Island countries can be addressed with a courageous will to reveal. It make more sense when it comes from the PLHIVs point of view..!