Despite advances in HIV treatment during the past 30 years, stigma and discrimination persist and continue to have a forceful impact on people living with HIV.
Stigma plays a great role in the global HIV epidemic and remains a great barrier to the health of people living with HIV. HIV-related stigma devalues and stereotypes people living with HIV, and it increases vulnerability to HIV infection by interfering with voluntary testing and counseling and reducing access to care and treatments. Hence, a better understanding of HIV-related stigma will facilitate the development of HIV prevention, treatment and care programs as well as help control global HIV infection rates.
HIV stigma occurs at both individual and societal levels. At the individual level, HIV stigma takes the form of personal behaviors, thoughts, and feelings that express prejudice against people living with HIV. For instance, people with HIV may suffer from social isolation and ridicule at work. At the societal level, HIV stigma is manifested in laws, policies, and popular discourses that marginalize people affected by HIV. For example, many local schools refuse to enroll HIV-positive children.
People are both the producer and the factor of the society, and these two levels of stigma interact with and reinforce each other. Concerns about stigma—both individual and societal affect an individual’s decision to get tested, access health care, and withhold information about their status from family members, friends, and care providers. This explains why so many people diagnosed with HIV feel ashamed and choose to stay silent and internalize the oppression.
One HIV stigma comes from the misuse of AIDS in mainstream media. Many still equate these four letters with death, although the HIV community no longer utters this term. Instead, HIV activists, doctors and service providers advocate ditching it for the more appropriate term—stage 3 HIV.
HIV and AIDS are not equivalent. HIV stands for human immunodeficiency virus, which destroys your immune system and leads to infection. AIDS is a threatening condition caused by HIV. It develops over time, and is usually considered as the final stage of HIV. In fact, most of those diagnosed with HIV today may never have AIDS.
Language is powerful. The incorrect use of AIDS overestimates the terminal, lethal, and stigmatizing consequences of the disease and misleads public attention to people dying from AIDS rather than people living with HIV. People lose jobs, people lose housing, and people lose their identities, once they receive a clinical diagnosis of HIV.
Moreover, HIV prevalence is disproportionately high in certain demographic groups, including men who have sex with men (MSM), communities of color, resource poor populations, women and young people. Because of their gender, race, class, sexual orientation, and drug use, these vulnerable populations become the center of public dialogues surrounding HIV and report higher level of HIV stigma and discrimination as well.
Intersectional effects of racism, sexism and gender discrimination contribute to double and sometimes multiple stigmas and stigmatization of people living with HIV, and HIV stigma in turn exacerbates existing stereotypes associated with these social identities. One group at the intersection of overlapping stigmatized identities is the female sex workers—as women, as poor, and as sex works.
Suffered from patriarchal norms and gender inequalities, female sex workers are labeled as promiscuous and immoral, and they often lack the power to resist the oppression. Moreover, because HIV is constructed as a disease of punishment for sexual transgression, female sex workers internalize these multi-layers of stigma and blame themselves for being infected with HIV. Consequently, these intersecting negative identities reinforce the stereotypes of sex workers as vectors of HIV, and the stigma also reconstructs female sex workers’ social identities.
Fortunately, we can fight stigma, and we must. Social work interventions need to dispel the myths and stereotypes about HIV and provide accurate information about how HIV is transmitted. Empowering people with HIV is important, especially minority populations who are already discriminated due to their social identities. People with HIV need to understand that they are not victims and that sharing their stories with family and friends helps tear down barriers and fear.
If you are diagnosed with HIV, see a HIV health profession as soon as possible. Don't put it off. Your HIV doctor will test your immune system and develop the best treatment plan with you to prevent exacerbations of the symptoms.
Also, you do not have to tell everyone about your status except your sexual partner. However, sharing your story will help you feel more like yourself and help other people overcome HIV stigma and live out with confidence as well. Believe it or not, there are many people around you who are either HIV-positive or have been affected by HIV in one way or another. The first time you tell someone may be scary, but it gets easier every time.
If you find your loved-one is HIV-positive, do not turn away. Listen patiently when he or she tries to explain the illness. Also, do some research to enrich your knowledge about HIV, so that you know you will not acquire HIV by hugging your loved one or sharing food and drinks. Educating people about the disease is key to removing stigma.