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Getting to Zero Stigma: A Positive Point of View

After more than thirty years since AIDS was first clinically observed in the United States, one might think that discrimination against people living with HIV would be a relic of the past. Well, think again. According to the Washington Post/Kaiser Family Foundation’s 2012 Survey of Americans on HIV/AIDS, 25% of Americans are unaware that HIV cannot be transmitted by sharing a drinking glass. What is even more alarming is the fact that this number is about the same as it was way back in 1987.

Yes, HIV stigmatism is still very much with us today, and in fact, it pervades much of our everyday life. Anyone who has browsed one of the many gay social/sexual networking apps would have seen some variant of the phrase “HIV negative, you be too” proudly declared on profiles – nevermind that there is comprehensive and conclusive evidence that proper condom use is effective in preventing the transmission of HIV. Lest you think that discrimination occurs only in sex-­‐related scenarios, a quick search on Youtube returns a video of a policeman telling a woman in Detroit on August 3, 2012 that he was issuing her a ticket because she failed to reveal her serostatus before he searched her vehicle. His justification? He has a family and does not want to “catch anything”. There is even some evidence suggesting that discrimination is not limited to the ignorant. At the 2012 Interscience Conference on Antimicrobial Agents and Chemotherapy (ICAAC), Daniel Pierce, MD, of Loma Linda University reported inequality in the way people with HIV were treated in hospitals for coronary artery disease. He found after studying the Nationwide Inpatient sample – a huge national database on hospitalized patients – that patients with HIV and coronary artery disease comorbidity were significantly less likely to receive heart attack medications and procedures than patients without HIV.

But why should we care? After all, not everyone who is HIV positive is an “innocent victim” who acquired the disease through blood transfusion or unprotected sex with a cheating partner, right? However one chooses to judge people living with HIV, the fact is that HIV stigmas interfere with prevention, diagnosis, and treatment. What this means is that the longer HIV stigmas remain with us, the greater the viral load will be in the community, and the greater the challenge of containing the epidemic. Stigmatism can impact treatment adherence, since patients may avoid taking their medications in situations with high potential for stigma, such as when having a meal with friends, relatives, or a new date who is still unaware of his/her serostatus. As is well known, drug adherence is crucial to preventing viral mutation and drug-­‐resistance – imagine the day when drugs no longer work to contain HIV because of something as silly as discrimination. Due to prevailing stigmatism, people living with HIV are also less likely to disclose their serostatus to potential sex partners, when ironically, it is safer to have (protected) sex with someone is aware of his/her serostatus and keeping his/her viral load undetectable through active treatment, than with someone who is unaware of his/her serostatus and could, possibly, be HIV positive with a high viral load that makes for easier transmission. In short, nobody wins as long as HIV stigmas remain in our society.

As someone who is HIV positive, the pain and fear of discrimination is real. Sadly, HIV stigmatism has become internalized for many, causing them to turn to substance abuse and other forms of self-­‐destructive behavior, resulting in an increased risk of addiction, mental disorders, and suicide. I count myself fortunate that I have not (yet) been affected by outwardly noticeable side effects of treatment, such as lipodystrophy, that make some of my brothers and sisters vulnerable to unavoidable stigma. Paradoxically, this puts me in a moral dilemma: On the one hand, I see the potential of empowering others like myself by coming out to the community that I am HIV positive, healthy and successful. Yet, on the other hand, I hesitate to do so precisely because of the pervasive stigma that shrouds the disease, which I fear may rob me of my opportunities to continue succeeding in life. For now, I can only long for the day when we live in a world without HIV or the stigma that surrounds it.


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