Fear surrounding the emerging HIV epidemic in the 1980s largely persists today. At that time, very little was known about how HIV is transmitted, which made people scared of those living with HIV/AIDS due to fear of contracting the disease.
The HIV epidemic continues to impact thousands of Americans each year, especially young Black men who have sex with men (MSM) and with Black women who bear a disproportionate burden of new transmissions. Despite the number of people who continue to be impacted by HIV, we have made significant progress in moving toward the end of the epidemic. Those accomplishments include the first-ever National HIV/AIDS Strategy, the availability of multiple antiretroviral medications as a single tablet regimen, new prevention strategies like Pre-Exposure Prophylaxis (PrEP), emerging tools such as microbicides and expanded access to health care as a result of the implementation of the Affordable Care.
The Black community and sexual minorities experience higher levels of race, sexual orientation, gender, and HIV status based institutionalized stigma compared to other groups. These experiences have an impact on access to health care and the quality of care individuals in these communities receive.
HIV-related stigma and discrimination exists worldwide, although it manifests itself differently across countries, communities, religious groups and individuals. Possible consequences of HIV-related stigma are:
- loss of income and livelihood
- loss of marriage and childbearing options
- poor care within the health sector
- withdrawal of care giving in the home
- loss of hope and feelings of worthlessness
- loss of reputation.
As a Black same-gender loving man who has worked in the HIV field for nearly 22 years with the support of a wonderful network of family, friends, and colleagues, I‘ve internalized some of the stigma perpetuated by the larger society around HIV, race, and sexual orientation.
One area negatively impacting those living with HIV in the African American community is the stigma associated with having HIV. Stigma can take two forms: felt or actual. Stigma that is felt occurs when there is a real or imagined fear of community attitudes regarding a particular condition and a concern that this could result in discrimination directed to individuals with that condition. Actual stigma refers to experiences of discrimination directed to individuals because of specific conditions that characterize them.
HIV-related stigma is closely associated with a number of negative consequences, including being labeled and stereotyped, experiencing separation from others, experiencing a loss in social status and being the recipient of actual discrimination and prejudice. Individuals living with HIV can be the target of such experiences from loved ones, such as family members and friends, as well as from coworkers, health care providers, employers, and others. Governmental public policies can also contribute to the stigmatization of HIV.
HIV stigmatization can harm the lives of those living with HIV in many ways. These can include a loss in self-esteem as well as deteriorated social interactions with others. Examples are depression, anxiety, loneliness, suicidal ideation, and poor treatment adherence. So, there are a number of negative consequences associated with stigma, and stigma itself is usually composed of items that consist of social rejection, financial insecurity, internalized shame and social isolation.
It is with education and perseverance that we as a society have come as far as we have, medically as well as psychologically; however, we still have a long way to go.
We have an opportunity to help those who are living with HIV, as well as the whole of society. People living with HIV have a number of issues to work through, the first being how to deal with the realization of living and the effect it will have on the rest of their lives. For a newly diagnosed person, there are myriad thoughts and emotions that go through a person’s mind.
We have an opportunity, as a community to educate and be educated about the disease and how we as a society can lend support. Through education, we can become advocates of social change as we educate society about the disease. There are some beliefs and misconceptions that are guided by fear and by ignorance; other beliefs and misconceptions guide hate, at times these two beliefs systems intertwine. It is by truth, understanding and compassion that we can help society through this epidemic. We can stand together as advocates!
World AIDS Day was founded in 1988 to honor those who have perished, as well as those who continually live with the disease. Dec. 1 was especially set aside by the United Nations and is marked on calendars worldwide as a day of remembrance and a day of education. Let us honor those who have perished from this terrible disease — by getting tested, utilizing prevention services, and educating ourselves about the facts and not by letting bias, misconceptions, and rumors drive our actions and perceptions.