By Sophie Roling, C'22
Despite the modern scientific advances that enable HIV positive people to live a full life with a suppressed viral load, the attitudes of many Americans have not changed to become more accepting of people living with HIV/AIDS. Today’s reality is that the stigma surrounding the initial surge of the HIV/AIDS epidemic in the 1980s still clouds the judgment of a significant number of Americans, causing perpetual emotional distress to HIV positive communities. At that time, HIV was a new threat to society. At that time, many people falsely believed that HIV was transmitted only through homosexual contact, which is and continues to be a taboo subject for religious and cultural reasons. These false beliefs allowed society to tie the virus to concepts of morality. Many marginalized communities, including LGBTQ+ and African Americans, experience disproportionately higher rates of HIV transmission. This alarming fact feeds into greater issues of structural racism and homophobia in the U.S. as these communities were spotlighted and blamed for transmission at the beginning of the epidemic, especially when issues of religion and morals became intertwined with public opinion on HIV transmission. Even today, while these communities continue to face oppression, the incidence of the virus continues to carry a moral weight. Minorities are often an easy scapegoat when society searches for answers in dealing with the emotional taxes of HIV/AIDS.
"Today’s reality is that the stigma surrounding the initial surge of the HIV/AIDS epidemic in the 1980s still clouds the judgment of a significant number of Americans, causing perpetual emotional distress to HIV positive communities."
A recent study showed that 17.5% of adults and 31.6% of adolescents from a sample of approximately 6800 adults and 900 adolescents were afraid of casual contact with individuals living with HIV. This usually means touching, but for some could simply mean being in close proximity to, a person who is HIV positive. Notably, casual contact is not a way to transmit the virus; it is most commonly spread through sexual contact or used/shared injection equipment. Additionally, only slightly fewer of those surveyed believed that individuals living with HIV have participated in immoral or illicit activities. This amounts to a little less than 1 in 5 adults or 1 in 3 adolescents being afraid of encountering HIV positive people, and nearly as many people perceiving HIV positive individuals as immoral.
These numbers are concerning for a variety of reasons. Stigma affects people personally and emotionally. Because of this, many individuals are less likely to seek out testing, treatment, and routine physician visits. They might also be less likely to disclose their status to partners. The combination of all these factors contributes to viral transmission and perpetuates the issue. In Philadelphia alone, there are 30,000 people living with HIV. Philadelphians are infected at a rate five times that of the national average. Philadelphians also struggle with the effects of the opioid epidemic. The issues of sharing needles coupled with the stigma of being identified as an HIV positive person by way of immoral activity play large roles in the spread of the virus.
Clearly, the health and emotional wellness problems associated with HIV are exacerbated by the social stigmatization of the virus. Fear is an extremely powerful emotion. The fear of being stigmatized by others could help to explain why these statistics are so alarming, and could guide us to some solutions in lowering the rate of transmission in Philadelphia. Many organizations in Philadelphia are taking action to slow the spread by offering safe injection sites, testing and treatment, contraception, and other tangible forms of support. A few other Philadelphian organizations offer counseling services. Tackling the systemic issues of stigma, however, proves to be more difficult. In order to reduce stigma and increase tolerance in the future, different personal and communal interventions have been recommended by health experts and policymakers. Social interventions such as mass-media education, empathy induction (seeing others’ struggles to promote altruistic behavior), and counseling are some potential solutions. But the issues of stigma can also be tackled at a policy level: normalizing and instituting routine testing (as encouraged by many local advocacy organizations) and mandating education in public schools are just some of the ways HIV awareness can slowly work its way into the community and dissipate stigma.
At UNAIDS at Penn, we strive to raise awareness and build community within West Philadelphia and at UPenn with the hopes of ending the societal stigma around HIV/AIDS. We hope that the efforts of our team, along with the many fabulous Philadelphia-based organizations, will continue to make an impact. The process will take time and cooperation, but it will undoubtedly help to move our society forward in terms of eradicating HIV/AIDS and the stigma associated with it.