HIV/AIDS: Breaking the Stigma


by Manny Mendoza, MD | mendoza@myhousecallmd.com

Let’s talk about sex! Okay, by sex we mean sexually transmitted diseases and one in particular: HIV/AIDS. Did you know that it has been thirty years since the virus that changed sexual politics and sexual health forever was discovered? Did you know that the stereotypical face of HIV/AIDS is no longer what it used to be? Many people believe that HIV/AIDS is an illness that exclusively affects the gay community.  Although men who have sex with men (MSM) remain the largest single affected community (representing more than half of all new HIV infections) the virus has also become a serious threat to African Americans, Latinos, and women.

Let’s talk numbers. According to the Center for Disease Control, approximately 1.1 million people in the U.S. are living with HIV. An estimated 50,000 are infected every year, a number which has remained fairly stable since the mid-1990’s but represents a significant improvement from roughly 130,000 a year at the epidemic’s height in the 1980’s. Men who have sex with men (MSM), although comprising a smaller majority of HIV infections than they did at the epidemic’s height, represent an increasing number of new infections, due in large part to a significant increase in transmission amongst young black MSM. But sex between MSM is, by no means, the only way the virus is transmitted.

Did you know that heterosexual transmission is responsible for 27 percent of new infections? This is followed by injection drug use, which accounts for 9 percent of new infections. While odds are good that you’re not an IV drug user, statistically, there’s a good chance you’re a sexually active heterosexual.  Ladies, it’s time to start having important conversations with your partners. The demographic that is at greatest risk for HIV is people who are sexually active…and a lot of people are having sex! Transmission is not about sexual orientation; it’s about sexual activity.

While a decent portion of the population is having sex, there are specific groups that are disproportionately affected by HIV: ethnic and racial minorities. African Americans account for the highest number of new HIV infections per year, followed by Latinos. Although only 14 percent of Americans are black, 45 percent of new HIV infections occur in the black community. Latinos account for 16 percent of the U.S. population but are diagnosed with 20 percent of new HIV infections each year.  “What is causing this discrepancy?” The most commonly cited explanations are socioeconomic: lack of access to health care, racial discrimination, and poverty all place people of color at greater risk of contracting the virus. Studies have also correlated a number of other factors with HIV incidence, albeit to a lesser degree, including poverty, homophobia, sexism, and racism.

Let’s switch gears for a minute.  We now know that HIV is an infection that any sexually active individual can contract.  The next step is awareness, education, and support. Once considered certain death, HIV/AIDS is now largely seen as a manageable chronic disease (look at Magic Johnson!).  While the fight for a cure continues, there is one aspect of the epidemic that has not changed: stigma. HIV/AIDS stigma continues to plague those infected as well as their families, friends, and partners. Stigma is perceived as a major limiting factor in primary and secondary HIV/AIDS prevention and care. It has interfered with voluntary testing, counseling, and access to care and treatments. About 34 million people are infected with HIV globally…leading to 25 million deaths! Yet another discrepancy.  While we don’t have an HIV vaccine, we do have a powerful combination of medications HIV/AIDS care arsenal called Highly Active Antiretroviral therapy (HAART) that can keep the virus suppressed.  The key is getting these medications into the hands of infected individuals.  And what is preventing that?  Stigma.  Stigma and discrimination prevent many individuals infected with HIV/AIDS from discovering their diagnosis and/or seeking treatment.

Don’t believe this stigma exists?  Here are a few examples in our current society:

  • Referring to HIV as “AIDS.”
  • Presuming that someone who is HIV-positive is sick, contagious, or dying.
  • Believing HIV can be contracted by casual contact or kissing.
  • Using the word “clean” when referring to a negative HIV status
  • Judging someone who is HIV-positive when they disclose their status.
  • Trusting that every sexual partner will be honest in disclosing his/her HIV status.
  • Labeling HIV-positive people as promiscuous.
  • Discussing someone’s HIV status, be it rumor or factual, without their consent or knowledge.
  • Refusing to be tested for HIV for fear of a positive result.

While the scientists of the world hunt for the cure to HIV, you can do your part by raising awareness about HIV/AIDS and refuting the stigmas that surround the virus. You don’t have to be a biomedical engineer (or a former US President leading the charge with the nonprofit organization you founded) to make a difference!

Questions? E-mail the Author: mendoza@myhousecallmd.com

References:
1. Luiggi, C. Mapping HIV in the US. The Scientist. June 3, 2011.
2. Black Coalition on AIDS. Health Issues: HIV/AIDS. 2009.
3. AIDS.gov. HIV/AIDS 101: U.S. Statistics. June 6, 2012.

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