Causecast

By Susan Blumenthal, MD, and Melissa Shive

For two months, ostracized and alone, nineteen year-old Marvelyn Brown slept on the gray vinyl seats of her 1996 Nissan Sentra in the parking lot of a Nashville, Tennessee, Walmart. When she visited her family, she used paper plates and plastic forks to eat so she wouldn’t share dishes; all surfaces that she touched were wiped down with bleach. Her newly pregnant friend told her that she did not want Marvelyn around her child. In a matter of a few weeks, Marvelyn had lost the support of her friends and family—all because she had been diagnosed as HIV positive.

But Marvelyn’s story is neither new nor unique. Her friends and relatives were suddenly confronting the realities of a potentially life-threatening infectious disease, and they responded to their lack of understanding about HIV/AIDS as many people do—with fear and mistrust.

Today is the 20th anniversary of World AIDS Day, and its message, “Stop AIDS. Keep the Promise,” calls on global leaders to deliver on the promise of universal access to prevention, treatment, and care. Yet, despite two decades of progress in the fight against this disease, there is still widespread stigma surrounding HIV/AIDS in the United States and across the world—fueled by myths, a lack of knowledge about how the disease is transmitted, and value judgments about how it is acquired. Though many people are familiar with the concepts of ageism and racism, there is another pervasive, pernicious form of discrimination that deeply affects many people’s lives and must also be given a name—“aidsism.”

Stigma, or aidsism, is a major barrier to HIV prevention, diagnosis, care, and treatment. A national survey conducted last year by amfAR, The Foundation for AIDS Research, on HIV stigma in women found that one in five respondents would be uncomfortable even having a close friend who was HIV positive, and 59 percent would be uncomfortable with an HIV-positive woman as a child care provider. Since 1990, there has been no change in the percentage of Americans who mistakenly believe that HIV can be transmitted by kissing (37%), sharing a drinking glass (22%), or touching a toilet seat (16%).

Twenty-seven years after the emergence of HIV, first reported in San Francisco, AIDS has become an inextricable part of the modern world, with every country now reporting HIV infection rates. With 33 million people worldwide and 1.1 million people in the United States living with HIV/AIDS, this disease cannot be ignored.

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Photo: littledan77/Flickr