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Stigma and AIDS: Three Layers of Damage
Alvin Novick, MD
Stigmata associated with HIV/AIDS can be organized into three layers. First, over 95% of persons with AIDS in the United States belong to social groups whose fundamental human rights had been truncated long before HIV had appeared-gay men, injection drug users, African-Americans, Hispanics, and sex workers. All of these people had been isolated, ostracized, or constrained by law and/or tradition from occupying full citizenship. Long-term stigmatization has profound effects on the lives of the disdained, including the development of counterculture. In the case of gay men, for example, stigmatization led widely to creating and fostering a milieu of short-term, often anonymous, relationships as opposed to monogamy. Thus society's attitudes actually caused AIDS by guaranteeing transmission of HIV. And, finally, stigmata intrude on prevention, in that society is inhibited from creating or supporting programs that are humane and sensitive to the needs of vulnerable people.
Correspondence should be directed to Alvin Novick, MD Department of Biology Yale University PO Box 208104 New Haven, Connecticut 06520-8104
