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Stigma Still Attached to HIV

WebMD Health News

Nov. 30, 2000 -- One in five Americans has an unfavorable attitude toward people living with HIV infection, according to a large-scale survey published in the Dec. 1 issue of the CDC's Morbidity and Mortality Weekly Report.

"It is important to understand that stigma surrounding HIV infection still exists -- it has not gone away, and it is something we need to continue to address," CDC deputy AIDS chief Ronald O. Valdiserri, MD, MPH, tells WebMD. "We may be three decades into the epidemic, but we are still at a level of stigma that is unacceptably high."

The survey enlisted almost 7,500 adults from all parts of the country. In return for agreeing to participate in weekly surveys, they received Internet access via television. Of the more than 5,600 people who responded to the HIV stigma question, nearly 20% agreed with the statement, "People who get AIDS through sex or drug use have gotten what they deserve."

"That is a fifth of the population -- if 20% of people still think that, our battle against irrational hatred is not yet won," Mindy Fullilove, MD, tells WebMD. A professor of clinical psychiatry and public health at Columbia University, Fullilove has long worked on the problem of HIV transmission in high-risk communities.

This stigmatizing attitude was most frequently expressed by men, whites, people age 55 and older, people with no more than a high school education, people with an income of less than $30,000, and those in poor health. Blacks were far less likely to hold this attitude than other racial groups.

Ignorance appears to be one reason for stigmatizing people with AIDS. People who did not know that HIV cannot be transmitted by a sneeze or cough were twice as likely to stigmatize AIDS patients as those who did know. An appallingly high proportion of those surveyed -- more than 41% -- think a person could catch AIDS from a sneeze. This is only a little better than in China, where 49% of people believe this fallacy, according to a Peoples University of China survey reported by Reuters.

University of California at Davis psychology professor Gregory Herek, PhD, has conducted nationwide surveys of AIDS attitudes and knowledge for more than 10 years. "Notions that HIV can be spread by casual contact are closely linked to stigma," he tells WebMD. "To the extent people can be put into categories, people whose misinformation is based on distrust of what the government says tend not to be angry or disgusted with AIDS patients, but just worried that they themselves might get infected. For another group there is a condemnation of gay men and intravenous drug users that leads to punitive attitudes -- those are the ones who say it is their own fault. It's not a clear and simple thing."

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