Stigma is a virus that we all can cure. After 33 years, we now know more about HIV than ever. We have miraculous treatments, which can double as prevention. Today, science can help stop the disease with treatment, but it alone cannot end AIDS. We can’t get those living with HIV on treatments if they’re afraid to disclose their status because of stigma or homophobia.
Since the beginning of the epidemic for many HIV positive people, the reality of being ostracized, devalued, rejected, scorned and even murdered is real. Those who are HIV positive may experience psychological distress, and many viewing themselves contemptuously.
By making life difficult for those living with HIV, stigma can prevent open discussion about behaviors that can result in infection and some actions that one can take to prevent being infected. The fear of stigma has stopped many people from testing, and thus will not seek treatment until they’re sick or dying, while not taking precautions to prevent infecting others.
Most stigmatized groups come with symbols, such as skin color, hearing aids, canes, shaved heads or wheelchairs, you can’t tell someone is HIV positive based on looks. Most HIV stigma comes from testing and disclosure which looks and may feel different on a individual level. Increases in a chance of being stigmatized can depend on your geographic location in the U.S. For example, disclosing at a clinic in a metropolitan area such as Oakland, CA is much different from disclosing in a small town in North Carolina, where your pharmacist might attend your church. One of the biggest stigma fears for a lot of HIV positive heterosexual black men is the fear of being perceived as homosexual, when disclosing.
Studies show the impact of HIV related stigma on care is significant. A self reported study to evaluate the effects of concerns attributed to stigma, sampled 204 people living with HIV. Participants with high HIV concerns proved to be 3.3 times more likely to be non-adherent to their medication regimen than those with low concerns. This study shows that the threat of social stigma can prevent people living with HIV from revealing their status to others, which causes obvious health concerns to society. Clinical care directed to individuals living with HIV should include consideration of a patient’s sensitivity to social stigma.
Social stigmas come in many different forms. There is internal stigma, where the person stigmatized believes the negative things about themselves and there is external stigma, where others make the stigmatized person feel different, devalued and tainted. This happens in the workplace, educational settings, healthcare, criminal justice systems, and even in their own families. Members of stigmatized social groups often face prejudice or just the fear of prejudices can cause depression threatening a person’s social identity like low self esteem.
The experience of being stigmatized may also take a toll on self esteem, academic achievement, and other outcomes, but many people get through it, maintaining high self esteem, are happy and quite resilient to the negative experience. Today stigma endures, remaining a powerful barrier to African Americans that need HIV care, but it is not inevitable and can be fixed. We must first challenge the blemish that is part of being diagnosed with HIV and challenge the internalized disgrace of the stigmatized.
African Americans must educate themselves to the facts on why we shouldn’t stigmatize. We should create and support legislation against any form of discrimination. Let our community mobilize and participate in anti-stigma efforts. The power of a single action or person can influence others to move from inaction to action. It’s time to say “Stigma stops here”.