With the introduction of antiretroviral drugs years ago, contracting the human immunodeficiency virus (HIV) is no longer the death sentence it used to be. But, even if people are living longer with HIV, the number of people infected in general, especially in populations that are most vulnerable to being infected, remains a concern. The goal of having no new infections is achievable partly by removing the stigma surrounding HIV/AIDS (acquired immune deficiency syndrome, the chronic, life-threatening disease HIV can cause) and through successful prevention methods.
HIV can affect anyone regardless of sexual orientation, race, ethnicity, gender or age. However, misconceptions and assumptions about who gets the virus are still common. People make judgments about those who have HIV, how they got it or whether they “deserve” to have the virus.
Ken S. Ho, MD, MPH
“Having an infection of any sort isn’t a commentary on the kind of person you are or the value you have in society. It’s just an infection,” says Ken S. Ho, MD, MPH, assistant professor of medicine and medical director, Pitt Men’s Study, University of Pittsburgh School of Medicine. “Viruses don’t discriminate; they don’t follow our human perceptions of what ‘good’ or ‘bad’ are.”
HIV stigma can lead to discrimination, which can lead to a general unwillingness to discuss HIV at all. Secrecy about the virus is part of why people get or suffer needlessly from HIV. When people feel they cannot discuss HIV openly or reveal their status, they may not receive appropriate medical care—even when effective HIV treatment is available.
In addition to stigma, other factors may contribute to people living with HIV not getting the care they need. For example, the Centers for Disease Control and Prevention (CDC) reports that African Americans account for a higher proportion of new HIV diagnoses and people with HIV compared to other races and ethnicities. But this disparity exists largely as a result of social determinants of health—the conditions in which people live, grow and work that are also affected by complex social and economic structures.
“Data show that Black and Brown communities are disproportionately affected by HIV,” says Dr. Ho. “Sometimes people take that statement and turn it into more stigma—as in, if you’re from a certain population, then you must be doing something bad that makes your rates of HIV higher. That’s not true. In fact, higher rates of HIV boil down to things like the lack of health care access, including HIV prevention education, or mistrust of the medical community. These factors contribute to people not getting the testing, treatment or prevention they need to improve health or prevent HIV.”
Fortunately, years of biomedical research has led to effective HIV prevention. In addition to using condoms to protect against HIV (and other sexually transmitted infections), pre-exposure prophylaxis—or PrEP—is medicine taken daily to prevent getting HIV from sex or injection drug use. The CDC reports that PrEP, when taken as prescribed, reduces the risk of getting HIV from sex by about 99% and reduces the risk of getting HIV by at least 74% in people who inject drugs. Even though there is a perception that only men who are gay take PrEP, Dr. Ho says that there is nothing about the concept of preventative medication that is specific to the gay population. He likens using PrEP to using a seatbelt—an essential preventative measure.
“We have effective ways to prevent and treat HIV, and it would be great to focus on them and how we can help vulnerable populations instead of stigmatizing people who want to talk about HIV or who have it,” says Dr. Ho.
Another way to reduce HIV stigma is to become more informed about it and even help researchers learn more about the virus. The HIV Prevention Research Registry is open to people who are HIV-negative and HIV-positive. The registry exists to help researchers identify and contact people who may be able to participate in future research studies including HIV vaccine research. To learn more about the registry, contact Sherri Karas Certo, Pitt CRS clinical recruiter and community educator, at 412-383-1313 or sjk91@pitt.edu.
Vector medical poster AIDS. Getty Images stock illustration
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