Stigma—Still the Biggest Challenge to Early HIV/AIDS Testing and Treatment

Many of today’s youth are already starting to view gender and sexuality as a continuum—people are not simply a man or a woman, homosexual or heterosexuality. There is much more fluidity and flexibility in sexual expression and partner choice. But that’s the next generation. Many adults today, including those in high-risk populations, are still plagued by rigid gender norms and behavioral expectations, and when compounded by cultural identities, the stigma of being “other” or “infected” keeps many people from seeking the testing and treatment that could be the difference between a relatively normal life and a significantly shorter one full of suffering.

The Roots of Stigma

The stigma of HIV/AIDS is not an easily definable thing. It does not present a uniform experience for everyone at risk, everyone who suspects they have contracted the virus, everyone who seeks testing or everyone undergoing treatment. Rather, “stigma” is a complicated phenomenon that arises from the interplay of a number of factors, which may include:

  • Core cultural values, particularly in communities who define their values in religious terms

Many communities have historical and religious foundations on which their definitions of a “normal” relationship and “moral” behavior rest. For instance, communities that share a Judeo-Christian ethic often insist that marriage (and intimate relationships) should only be between a man and a woman and that lifelong monogamy (with a single partner) is the ideal to which every couple should aspire. As a result, people raised within these cultural constructs often feel shame if their sexual identity, preferences and behaviors deviate from these core values, and they hide their “sins” by refusing testing or keeping their HIV status and treatment secret.

  • Race/ethnicity

People who identify strongly with a particular racial or ethnic community may also face stigma if that community, like communities unified by core (religious) values, are heteronormative. For instance, historically, the Latin community has prized machismo, which requires: 1) that males identify as strictly masculine, an identity that pre-defines interests, behaviors, careers, etc. and 2) men partner with (dominate) a woman. Ethnic identities with strongly defined gender roles marginalize those who do not neatly fit within the gender/sexual boundaries, again, fostering shame that hinders individuals from getting help when their sexual identities, preferences and behaviors put them at greater risk for HIV infection.

  • Age

Although sexual maturity is starting to be achieved earlier, particularly in girls, American culture resists recognizing tweens and teens as sexually mature until later teen years, often using educational milestones (like high school graduation) as a means by which to gauge “adultness.” As a result, sexually mature “children” are sexually active, and therefore, at higher risk for HIV/AIDS, but without the educational or medical resources they need to prevent infection and/or effectively address virus transmission.

Most individuals who face stigmatization because of HIV diagnosis are often at the intersection of a number of root causes. In other words, minority youth and minority LGBTQ+ individuals are more likely to face stigmatization at all, face stigmatization that may feel more intense and/or seek to minimize stigma by refusing to seek testing and/or treatment.

How to Combat Stigma

Diminishing the stigma around HIV/AIDS is no easy task, and it certainly is not a task that individuals who need education, testing and/or treatment for HIV/AIDS should bear alone. To more effectively and quickly break down the stigma associated with HIV diagnosis, it will take a collective effort. You can contribute by:

  1. Educating yourself on HIV/AIDS

Historically, HIV/AIDS has been seen as a “gay disease” or a disease of the morally depraved. While LGBTQ+ communities do face a higher risk, they are, by no means, the only high-risk group. Heterosexuals, particularly women in heterosexual relationships, are just as susceptible to virus transmission. In fact, what contributes to increased risk in heterosexual populations is unhealthy relationship dynamics that discourage a partner from asking about virus status or requesting a partner to use prophylactics.

  1. Promoting HIV/AIDS awareness and resource awareness

Take the opportunity to learn about safe sex/HIV prevention practices and pass along what you know. Use your social media to promote awareness of community events or resources for education, testing and treatment. Vote for local initiatives that fund HIV/AIDS resources so that testing and treatment are available at low or no cost to your community.

  1. Speaking up and speak out for those who have experienced marginalization because of HIV diagnosis

The stigma surrounding HIV/AIDS has been so long-lived largely because of silence. You don’t have to join nationwide marches to voice your dissent. Simply have the courage to speak up when an acquaintance or friend makes a comment driven by outdated, judgmental views or post your respectful and informed response to hurtful posts on social media platforms.

For more opportunities to break down the stigma associate with HIV/AIDS, please contact UNM Truman Health Services. Our community outreach events and free educational resources are an excellent place to start raising your own awareness about a global human issue.