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Social Stigma of HIV
Social Factors
The spread of HIV will not only be halted by medical means there are a number of social issues that need to be addressed.
Reduce levels of poverty in society that lead to increased risks through drug abuse and promiscuity.
Provide HIV testing and counselling to identify infected persons who can reduce their risk to others.
Provide educational programs for children and adults which describe how to avoid sexually transmitted diseases.
Promote sexual barrier precautions among high risk commercial sex workers and clients.
Provide clean needles for injection drug users.
Create health care programs providing antiretroviral therapy to extend life and reduce HIV transmission rates.
Give HIV-infected pregnant women antiretroviral therapy to reduce perinatal HIV transmission.
Stigma
The main social issue attached to HIV is that of stigma.
From the moment scientists identified HIV, social responses of fear, denial, stigma and discrimination have accompanied the epidemic. Discrimination has spread rapidly, fuelling anxiety and prejudice against the groups most affected, as well as those living with HIV. It goes without saying that HIV are as much about social phenomena as they are about biological and medical concerns.
Across the world the global epidemic of HIV has shown itself capable of triggering responses of compassion, solidarity and support, bringing out the best in people, their families and communities.
But the disease is also associated with stigma, repression and discrimination, as individuals affected (or believed to be affected) by HIV have been rejected by their families, their loved ones and their communities. This rejection holds as true in the rich countries as it does in the poorer countries.
Stigma is a powerful tool of social control. It can be used to marginalize, exclude and exercise power over individuals who show certain characteristics. Society rejects the social groups associated with HIV (e.g. 'homosexuals, injecting drug users, sex workers'). By blaming certain individuals or groups, society can excuse itself from the responsibility of caring for and looking after such populations.
In many societies people living with HIV are often seen as shameful. In some societies the infection is associated with minority groups or behaviours, for example, homosexuality, In some cases HIV may be linked to "perversion" and those infected will be punished.
Also, in some societies HIV is seen as the result of personal irresponsibility. Sometimes, HIV are believed to bring shame upon the family or community. And whilst negative responses to HIV unfortunately widely exist, they often feed upon and reinforce dominant ideas of good and bad with respect to sex and illness, and proper and improper behaviours.
Factors which contribute to HIV related stigma:
HIV is a life-threatening disease when advanced into the AIDS stage.
People are scared of contracting HIV
The disease's association with behaviours (such as sex between men and injecting drug-use) that are already stigmatised in many societies
People living with HIV are often thought of as being responsible for becoming infected
Religious or moral beliefs that lead some people to believe that having HIV is the result of moral fault (such as promiscuity or 'deviant sex') that deserves to be punished.
In some societies, laws, rules and policies can increase the stigmatisation of people living with HIV. Such legislation may include compulsory screening and testing, as well as limitations on international travel and migration. In most cases, discriminatory practises such as the compulsory screening of 'risk groups', both furthers the stigmatisation of such groups as well as creating a false sense of security among individuals who are not considered at high-risk.
Stigma and discrimination can arise from community-level responses to HIV. The harassing of individuals suspected of being infected or of belonging to a particular group has been widely reported. It is often motivated by the need to blame and punish and in extreme circumstances can extend to acts of violence and murder. Attacks on men who are assumed gay have increased in many parts of the world, and HIV related murders have been reported in countries as diverse as Brazil, Colombia, Ethiopia, India, South Africa and Thailand. In December 1998, Gugu Dhlamini was stoned and beaten to death by neighbours in her township near Durban, South Africa, after speaking out openly on World Aids Day about her HIV status.
HIV and Women
The impact of HIV on women is particularly acute. In many developing countries, women are often economically, culturally and socially disadvantaged and lack equal access to treatment, financial support and education. In a number of societies, women are mistakenly perceived as the main transmitters of sexually transmitted diseases (STDs). Together with traditional beliefs about sex, blood and the transmission of other diseases, these beliefs provide a basis for the further stigma of women within the context of HIV
HIV - positive women are treated very differently from men in many developing countries. Men are likely to be 'excused' for their behaviour that resulted in their infection, whereas women are not.
"My mother-in-law tells everybody, 'Because of her, my son got this disease. My son is a simple as good as gold-but she brought him this disease".
(HIV-positive woman, aged 26, India)
In India, for example, the husbands who infected them may abandon women living with HIV. Rejection by wider family members is also common. In some African countries, women, whose husbands have died from HIV-related infections, have been blamed for their deaths.
Family
In the majority of developing countries, families are the primary caregivers to sick members. There is clear evidence of the importance of the role that the family plays in providing support and care for people living with HIV. However, not all family response is positive. Infected members of the family can find themselves stigmatised and discriminated against within the home. There is also mounting evidence that women and non-heterosexual family members are more likely to be badly treated than children and men.
"My mother-in-law has kept everything separate for me-my glass, my plate, they never discriminated like this with their son. They used to eat together with him. For me, it's don't do this or don't touch that and even if I use a bucket to bathe, they yell- 'wash it, wash it'. They really harass me. I wish nobody comes to be in my situation and I wish nobody does this to anybody. But what can I do? My parents and brother also do not want me back."
(HIV-positive woman, aged 23, India)
Workplace
While HIV is not transmitted in the majority of workplace settings, the supposed risk of transmission has been used by numerous employers to terminate or refuse employment. There is also evidence that if people living with HIV are open about their infection status at work, they may well experience stigmatisation and discrimination by others.
"Nobody will come near me, eat with me in the canteen, nobody will want to work with me, I am an outcast here".
(HIV positive man, aged 27, India)
In poorer countries screening has also been reported as taking place, especially in industries where health benefits are available to employees. Employer-sponsored insurance schemes providing medical care and pensions for their workers have come under increasing pressure in countries that have been seriously affected by HIV. Some employers have used this pressure to deny employment to people with HIV.
"Though we do not have a policy so far, I can say that if at the time of recruitment there is a person with HIV, I will not take him. I' ll certainly not buy a problem for the company. I see recruitment as a buying-selling relationship. If I don't find the product attractive, I'll not buy it."
(The Head of Human Resource Development, India)
Social Barriers against fighting HIV
Stigma
HIV-related stigma and discrimination remains an enormous barrier to effectively fighting the HIV epidemic. Fear of discrimination often prevents people from seeking treatment for AIDS or from admitting their HIV status publicly. People with or suspected of having HIV may be denied employment, refused entry to foreign country. In some cases, they may be evicted from home by their families and rejected by their friends and colleagues. The stigma attached to HIV can extend into the next generation, placing an emotional burden on those left behind.
Denial
Denial goes hand in hand with discrimination, with many people continuing to deny that HIV exists in their communities. Today, HIV threatens the welfare and well being of people throughout the world. At the end of the year 2000, 36.1 million people were living with HIV and during the year 3 million died from AIDS-related illness. Combating the stigma and discrimination against people who are affected by HIV is as important as developing the medical cures in the process of preventing and controlling the global epidemic.
So how can progress be made in overcoming this stigma and discrimination?
Education and knowledge - if people were to know and understand about HIV then stigma would reduce.
Upholding the rights of those who are affected with HIV - protecting them from discrimination in the workplace and home.
