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Beauty tames beast of HIV stigma


GABORONE, Botswana -- Five years ago, when Cynthia Leshomo discovered she was HIV-positive, she swallowed a bottle of the anti-retroviral pills prescribed for her and slipped into a coma for two days.

"I thought I was cursed, a black sheep in the family," said the young business school graduate, who had an AIDS-related tumor in her stomach and whose weight had slipped to a skeletal 75 pounds. "I thought, 'Why me?' I couldn't face the stigma."

On Saturday night, however, a now happy and beautiful Leshomo showed off just how far she--and Botswana--have come in combating that same stigma, sashaying away with a bouquet of flowers, a scholarship and a prestigious new title: Miss HIV Stigma Free.

"I'm here to empower people," said the beaming 32-year-old in an orange-and-white evening gown, as she accepted a crown of flowers and kisses from admirers at Gaborone's convention center, home to the world's first beauty pageant for HIV-positive women.

More than a third of adults in Botswana carry the virus that causes AIDS, and in the last several years the southern African nation of 1.7 million has become the continent's leader in providing free anti-retroviral drugs.

But battling the stigma surrounding AIDS is another matter in Botswana, as in most of Africa. Despite the widespread availability of testing and treatment, many Batswana--as Botswana's citizens are known--avoid AIDS tests or hide their positive status. Across the largely rural country, families still whisper about the neighbor who has lost too much weight or theystop calling friends who go to the local clinic a little too often.

"People look at this as something that has to do with one's moral behavior, so stigma is a major concern," said Dr. Patson Mazonde, director of health services for Botswana's Ministry of Health. Ending discrimination and encouraging HIV-positive people to go public with their status, he and others say, is vital to curbing the spread of the epidemic.

That's where Miss HIV Stigma Free comes in. In a nation where young women are disproportionately affected by the virus, the pageant is a way of showing that the HIV-positive need not be ashamed and that with treatment they can look good and live well.

"This has helped take the lid off the silence," said Dr. Ernest Darkoh, who oversaw the launch of the government anti-retroviral treatment program in 2001. "The truth is a person on treatment can run in the Olympics, can do anything. They are as beautiful and able and deserving as anybody else."

The pageant, organized by HIV counseling organizations, doesn't quite have the cache--or the cash--of bigger beauty pageants. The dozen contestants last week practiced their runway moves in an empty house in Gaborone's dusty suburbs and scrounged for money to buy shoes at the local mall. There was no dress rehearsal because the dresses arrived at the last minute.

Not just a pretty pageant

But the women, coached on snappy turns and smiling poses by the current Miss Botswana, still managed to strut under the lights looking terrific and not at all terrified as an audience of about 400 whooped and applauded, and photographers blinded them with flashes.

Unlike many beauty pageants, "this one's very meaningful," said Juby Peacock, Miss Botswana, as she helped the contestants--most in their 30s, many with children and a few extra pounds--with their dresses. "It's a very good thing."

The Miss HIV pageant, first held in 2002, initially got off to a rough start. Its first winner, chosen mainly for her good looks, was stunned by the widespread media attention, panicked and soon threatened the local media with defamation lawsuits if they revealed she was HIV-positive. The next year, pageant organizers made leadership, maturity, communication skills and knowledge about HIV the top judging criteria.

The next winner, Kgalalelo Ntsepe, a maid turned HIV counselor with less-than-perfect teeth but a heartfelt speaking style, went on to crisscross the country, talking to school groups and at public gatherings and urging HIV testing and anti-retroviral treatment, which she credits with saving her life.

"If you keep silent, fingers don't stop pointing at you," she told listeners. When one student suggested all those carrying the AIDS virus be killed to stem the epidemic, she reminded him that when Botswana tries to control cattle disease outbreaks, it culls infected cattle and those not yet tested, just to be safe. The student quickly backed down.

This year's contestants, in their pageant speeches, promised they would work to encourage more people--particularly prominent Batswana--to be tested and publicly reveal their status, and would focus on ensuring the disease isn't passed to the next generation.

"We are going to kill it, rather than it killing us," promised Elizabeth Remolale, 33, one of the contestants, who was once 42 pounds and bedridden. "We are going to fight until AIDS is finished here."

Small contestant pool

The competitors, who paraded in evening dresses, casual wear and traditional clothing, were--as in past years--nearly all employed as HIV counselors, at least since discovering their status. The contest has yet to attract many ordinary clerks or lawyers or housewives, one sign of the continuing stigma surrounding the disease.

But the pageant is gaining public support. Donors this year included big Botswana diamond mining businesses such as DeBeers, as well as cell phone companies, banks, airlines and even Holiness Union Church.

Leshomo, the winner, wowed the crowd with an enthusiastic smile, a traditional costume that included a bottle of anti-retroviral pills tucked in a clay pot and an eloquent promise to battle discrimination.

"Let us fight HIV and AIDS, let us fight stigma. Let us not fight the people with the virus," she urged.

In many ways, she has already won her own battle with the virus and the stigma surrounding it. Last year, at an AIDS conference in Bangkok, she met a fellow HIV-positive activist who has become her boyfriend. She is back at work, as an administrator for a government medical plan and hopes to begin a master's degree in public speaking soon. Her immune system, once nearly destroyed, has recovered with the help of anti-retroviral drugs.

Five years ago, "I was dead," she said. Now, "I've got my life back."


Copyright © 2005 -Chicago Tribune, Publisher. All rights reserved to Chicago Tribune. Reproduced with permission. Reproduction of this article (other than one copy for personal reference) must be cleared through the Chicago Tribune, Permissions Desk, 435 North Michigan Avenue, Chicago, IL 60611

Information in this article was accurate in February 28, 2005. The state of the art may have changed since the publication date. This material is designed to support, not replace, the relationship that exists between you and your doctor. Always discuss treatment options with a doctor who specializes in treating HIV.