Discrimination against people with HIV/AIDS
||It has been suggested that HIV exceptionalism be merged into this article. (Discuss) Proposed since May 2015.|
Discrimination against people living with HIV/AIDS ('PLHIV') is the experience of prejudice against PLHIV which falls within the purview of the law. Discrimination is one manifestation of stigma. Stigmatizing, attitudes, and behaviors may fall under the rubric of discrimination depending on the legislation of a particular country.
|Part of a series on|
HIV/AIDS stigma exists around the world in a lot of different ways, including ostracism, rejection, discrimination and avoidance. HIV testing without permission or security may be considered as wrongdoings towards those with HIV. compulsory HIV testing without prior consent or protection of confidentiality; violence against HIV infected individuals or people who are perceived to be infected with HIV; the quarantine of HIV infected individuals and, in some cases, the loss of property rights when a spouse dies. Stigmas that are violence or the fear of violence stops a lot of individuals for getting tested for HIV, which does not aid in curing the virus. This could make the virus spread further.
HIV/AIDS stigma has been further divided into the following three categories:
- Instrumental AIDS stigma—a reflection of the fear and apprehension that are likely to be associated with any deadly and transmissible illness.
- Symbolic AIDS stigma—the use of HIV/AIDS to express attitudes toward the social groups or lifestyles perceived to be associated with the disease.
- Courtesy AIDS stigma—stigmatization of people connected to the issue of HIV/AIDS or HIV- positive people.
In many developed countries, there is an association between HIV/AIDS and homosexuality or bisexuality (the CDC states, "Gay, bisexual, and other men who have sex with men (MSM) represent approximately 2% of the United States population, yet are the population most severely affected by HIV."), and this association is correlated with higher levels of sexual prejudice such as anti-homosexual attitudes. Many people also believe that aids are related to homosexuality. An early name for AIDS, gay-related immune deficiency or GRID, shows this prejudice. During the early 1980s, HIV/AIDS was considered "a disorder that appears to affect primarily male homosexuals".
Some forms of serious discrimination can include: not being permitted for a job, being prohibited to buy a house, have to pay extra money when renting a housing, etc. People who have or may HIV/AIDS, face a tremendous amount of discrimination in different areas of life. In the United States, disability laws prohibit HIV/AIDS discrimination in housing, employment, education, and access to health and social services. The U.S. Department of Housing and Urban Development's Office of Fair Housing and Equal Opportunity enforces laws prohibiting housing discrimination based on actual or perceived HIV/AIDS status.
Structural violence is an important factor in the treatment of people living with AIDS. Paul Farmer argues that social determinants affecting the lives of certain cultural groups alter their risk of infections and their ability to access treatment. For example, access to prophylaxis, access to antiretroviral therapy, and susceptibility to illness and malnutrition are all factors which change people's overall risk of illness due to HIV/AIDS. This causes large difference in the rate of illness due to HIV/AIDS in various social/cultural groups. Farmer also argues that social intervention may be key in altering the gap in treatment between these groups of people. Educating doctors on the interactions between social life and healthcare would help level out the injustices in healthcare.
Current research has found that discrimination against people living with HIV is a contributing factor for delayed initiation of HIV treatment. As many as 20-40% of Americans who are HIV+ do not begin a care regimen within the first 6 months after diagnosis. When individuals begin treatment late in the progression of HIV (when CD4+ T cell counts are below 500 cells/µL), they have 1.94 times the risk of mortality compared to those whose treatment is initiated when CD4+ T cells are still about 500 cells/µL. In a 2011 study published in AIDS Patient Care and STDs (sample size 215), most of the barriers to care described involve stigma and shame. The most common reasons of not seeking treatment are “I didn’t want to tell anyone I was HIV-positive”, “I didn’t want to think about being HIV-positive”, and “I was too embarrassed/ashamed to go”. The presence and perpetuation of HIV stigma prevents many who are able to obtain treatment from feeling comfortable about addressing their health statue.
- "The impact of AIDS on people and societies" (PDF). 2006 Report on the global AIDS epidemic (PDF). UNAIDS. 2006. Retrieved 2006-06-14.
- Huairou Commission http://www.huairou.org/sites/default/files/Women%20HIV%20LAND%20working%20draft%207-15-10%20-%20black%20and%20white%20version.pdf
- Herek GM, Capitanio JP (1999). "AIDS Stigma and sexual prejudice" (PDF). American Behavioral Scientist 42 (7): 1130–1147. doi:10.1177/0002764299042007006. Retrieved 2006-03-27.
- Snyder M, Omoto AM, Crain AL (1999). "Punished for their good deeds: stigmatization for AIDS volunteers". American Behavioral Scientist 42 (7): 1175–1192. doi:10.1177/0002764299042007009.
- Understanding HIV/AIDS Stigma and Discrimination http://www.socialworkers.org/practice/hiv_aids/AIDS_Day2012.pdf
- "CDC – Fact Sheet - Gay and Bisexual Men – Gender – Risk – HIV/AIDS". Retrieved 18 March 2015.
- Herek GM, Capitanio JP, Widaman KF (2002). "HIV-related stigma and knowledge in the United States: prevalence and trends, 1991-1999" (PDF). Am J Public Health 92 (3): 371–7. doi:10.2105/AJPH.92.3.371. PMC 1447082. PMID 11867313. Retrieved 2008-03-10.
- Lawrence K. Altman (May 11, 1982). "New Homosexual Disorder Worries Health Officials". The New York Times. Retrieved August 8, 2015.
- "FH_LGBT_PAGE". Retrieved 18 March 2015.
- "People with Disabilities - HUD". Retrieved 18 March 2015.
- Farmer, Paul; Bruce Nizeye; Sara Stulac; Salmaan Keshavjee (2006). "Structural Violence and Clinical Medicine".
- Pharris; et al. (2011). "Community patterns of stigma towards persons living with HIV: A population based latent class analysis from rural Vietnam". BMC Public Health 11: 705. doi:10.1186/1471-2458-11-705.
- Mugavero, MJ (2008). "Improving engagement in HIV care: What can we do?". Top HIV Med 16 (5): 156–161. PMID 19106431.
- Panel on Antiretroviral Guidelines for Adults and Adolescents (October 14, 2011). "Guidelines for the use of antiretroviral agents in HIV-1-infected adults and adolescents". Department of Health and Human Services.
- Pollini, Robin A.; Estela Blanco; Carol Crump; Maria Zuniga (2011). "A community-based study of barriers to HIV care initiation". AIDS Patient Care and STDs. 601-09.