Stigma Still Attached to HIV
"It is a human response to react negatively to what we can't understand and can't relate to," Valdiserri says. "We need to deal with that -- not only because it is the right thing to do, but because this has a significant impact on public health. If people are afraid to even admit they are at risk, then how can prevention work? Society has a real stake in addressing these issues."
The CDC already is planning to act. "We are conducting research to understand these attitudes, and we continue to work with faith communities -- which we feel are very important as stigma often has a moral or judgmental aspect," Valdiserri says. "The CDC also is working with White House Office of AIDS Policy to begin an advertising campaign to reduce stigma. It is scheduled to begin next spring. Also beginning next spring we will start up a training program of local HIV service providers. We have to teach the kinds of practical steps health providers can take to reduce stigma around HIV and AIDS."
CDC figures show that a third of the 4-5 million Americans with HIV infection do not know that they carry the AIDS virus. All of the experts contacted for this article stressed that AIDS stigma makes it hard for people to admit they are at risk of infection -- and keeps them from seeking the HIV testing, counseling, and treatment that can save their lives and keep them from spreading the disease.
"As long as we have a politics that says we respond to an epidemic only when we like the people who are sick, we have a grave threat to public health," Fullilove says. "It is disastrous health politics. Because the AIDS epidemic has been perceived as an epidemic of undesirables, it has been hard to get the kind of funding for education and treatment from the beginning. This has made it hard to teach people how to manage their lives in a new era of sexual behavior."