What to know about HIV stigma and discrimination

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Stigma occurs when there are negative beliefs and attitudes about a specific group of people. People living with HIV commonly face stigma, and others may label them as part of a socially unacceptable group.

An example of HIV stigma is incorrectly believing that only certain types or groups of people contract HIV. Another stigma that ties into this is assuming that people deserve to get HIV because of their life choices.

People may take sensible steps to prevent HIV transmission, and they may face stigma and moral judgments because of these actions.

HIV stigma is primarily due to a fear of HIV and a lack of knowledge about how HIV transmission occurs. However, most preconceptions about HIV date back to the HIV situation that first emerged in the 1980s, not necessarily the reality of living with the condition today.

While HIV stigma encompasses individuals’ attitudes and beliefs towards those with HIV, HIV discrimination includes the resulting behaviors. Essentially, those living with HIV may experience different treatment than HIV-negative individuals.

People living with HIV may experience various forms of discrimination. For example, they may encounter medical professionals who refuse to provide care or services because of their diagnosis. Discrimination also occurs if people refuse casual contact with them because of their HIV status.

Prejudice may also include derogatory language to those with HIV, such as referring to these individuals as “HIV-ers” or “positives.” These terms are extremely harmful, as they identify people with HIV by their condition as if it is the most important thing, or even the only relevant thing, about their identity. Some communities may even isolate someone with HIV if they learn about their status.

Sometimes bigotry occurs due to a lack of education, while other times, it results from practices and ideas that an individual grew up believing. No matter the cause, HIV discrimination is very harmful and can have a lasting impact on the individual living with HIV.

Continuously experiencing stigma and discrimination because of a medical diagnosis can negatively impact a person’s mental health and emotional well-being.

People living with HIV may internalize the stigma and bigotry they face, contributing to a negative self-image. In some cases, those with HIV may also have great fear and worry around the potential revelation of their condition to their community because of the injustice and discrimination they may face.

A common finding in people with HIV who experience bigotry is a phenomenon called “self-stigma.” This means that someone applies the stigmas associated with HIV to themselves. According to a Centers for Disease Control (CDC) study, almost 8 in 10 adults with HIV report these feelings.

Self-stigma can lead to:

• isolation
• shame
• despair
• fear of disclosure

Those with self-stigma may fear getting tested for HIV or receiving treatment, which can have detrimental health consequences. In addition, it may discourage those at risk of HIV from seeking HIV prevention testing and tools.

Another important aspect of HIV prevention is being open with sexual partners about safer sex options. However, HIV stigma may discourage these conversations. The CDC estimates that 2 out of 3 individuals with HIV find it challenging to tell others about their condition.

Individuals may face HIV discrimination in various aspects of their life, including education, the workplace, health care, and the justice system. On a more personal level, their own families and communities may discriminate against them, making them feel like they do not belong. According to the CDC, 1 in 4 individuals with HIV believes that being HIV-positive makes them feel dirty or worthless.

Currently, 35 states have specific laws that aim to control or criminalize behavior that could potentially expose another individual to HIV.

Although these laws serve to protect citizens, their implementation occurred early in the HIV epidemic when people knew little about HIV, its transmission, and treatment. Some laws even criminalize acts that cannot transmit HIV, such as spitting. Many are outdated because of advancements in HIV treatment and feed into HIV stigma as the same standards are not applied to other treatable conditions.

Furthermore, these laws may discourage sound HIV prevention practices such as testing and increase racial disparities, as they unfairly affect Black communities. In some states, the majority of those criminally prosecuted are African–American. These laws drive HIV stigma and have manipulated a public health issue into a crime.

A 2015 study found that the following helped enhance the confidence of those living with HIV:

• affiliation with support groups
• improved understanding
• family support
• financial independence
• presence of children

Focusing on these areas may prove invaluable for those coping with the stigma and discrimination of HIV.

Those with HIV may also find support and benefit from visiting a mental health professional such as a psychiatrist, psychologist, or therapist. These mental health professionals can help those with HIV find healthy ways to cope with stigma.

One of the essential steps in removing HIV stigma is to talk about the condition openly and normalize the subject.

In many cases, HIV stigma results from a lack of knowledge or misinformation surrounding the condition. Educating adults and children on the causes of HIV, how transmission occurs, and living with HIV removes some of the stigmas. In addition, it helps correct misconceptions about the condition.

Another critical aspect of HIV awareness is being mindful of comments about HIV and those living with it. People should be aware of the potential for discrimination and its harmful effects and take active steps to counter the stigma.

When communities are aware of HIV, it helps reduce stigma and discrimination and prevent HIV transmission. Additionally, awareness means that people with HIV can seek prompt and consistent treatment without fear of bigotry.

A stigma exists around HIV and those living with the condition. Discriminatory actions may stem from these harmful beliefs and attitudes and affect an individual’s health care, education, workplace, and more.

Those who experience HIV stigma and discrimination may not seek the testing and treatment they need. Additionally, it is common for those with HIV to experience self-stigma, where they begin to apply the stigma associated with HIV to themselves.

Spreading awareness about HIV stigma and discrimination is essential in reducing the spread of HIV and improving the lives of people living with this chronic health condition.