World AIDS Day 2017

The start of December brings about many things, including World AIDS Day.  This year’s theme is about ending the stigma of those living with HIV/AIDS (follow along on Twitter at #LetsEndIt). There is still a lot of misinformation about HIV/AIDS – remember a couple months ago when a Georgia state representative (and former anesthesiologist) recommended quarantining those with HIV to curtail the spread of the virus? Stigma and discrimination are some of the biggest barriers to HIV prevention, treatment, care, and support. Specifically, research has shown that stigma and discrimination undermine HIV prevention efforts by making people afraid to seek HIV information, testing, and services to reduce their risk of infection.

We see this all the time in clinic when we suggest a patient gets screened for HIV (“what? You think I could have HIV?!?  No, I don’t want to get the test…”). My patients have a much stronger reaction to the discussion around HIV screening than the reaction I get when I suggest screening for other infectious diseases. Research has also shown that fear of stigma and discrimination discourages people living with HIV from disclosing their status to family members and sexual partners, and undermines their ability and willingness to access and adhere to treatment. Thus, stigma and discrimination weaken the ability of individuals and communities to protect themselves from HIV and to stay healthy if they are living with HIV.  I’m fairly certain that a quarantine would further discourage someone from getting tested, disclosing their status, or seeking treatment. Not a good idea.

So, the stigma exists and it is negatively impacting people. How can we combat this stigma? The United Nations HIV/AIDS program released a great resource kit to reduce HIV-related stigma and discrimination. One way to decrease stigma is to increase information about HIV/AIDS, as ignorance often plays a key role in perpetuating stigma. The Center for Disease Control and Prevention has a great website where you can find accurate statistics about HIV/AIDS, as well as information about treatment, testing, and prevention. Other helpful websites include HIV.gov and the National Institute of Allergy and Infectious Disease, where you can find information about research, treatment clinical trials, and prevention efforts (including work towards developing a vaccine!).

Another strategy to decrease stigma is instituting (and enforcing) laws making discrimination against people with AIDS a punishable offense.  People living with HIV/AIDS are protected against discrimination under the Americans with Disabilities Act. There have been some high profile lawsuits regarding discrimination; notably Geoffrey Bowers, who sued his employer in the late 1980’s for wrongful dismissal after he was fired when his employer found out he had AIDS (his story was the basis for the movie Philadelphia). Sure, discrimination happened in the 1980s, but does it still happen today?  You bet it does. The Americans with Disabilities Act website publishes HIV/AIDS discrimination legal pursuits, and there are some from 2017, including a hospital that refused to care for a patient with HIV and a school excluding students from class and extracurricular activities due to a family member’s HIV diagnosis. Come on, people – we can do better than this!

It’s time to end the stigma around HIV/AIDS. Once this stigma is gone, people will be more willing to get screened, better adhere to treatment, and the quality of life of people living with HIV/AIDS will greatly improve.

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