Stuck in the ’80s

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11 Sep 2014

Medical science may have advanced in leaps and bounds but, as Christopher Kelly reports, the past three decades has seen attitudes toward people living with HIV remain in a shoulder-padded time warp.

A key objective of AIDS 2014 was “to broaden the understanding that the same barriers that have fuelled the epidemic over the past 30 years still exist today”. Stigma continues to be a barrier. And it’s as impenetrable as ever.

Known for not mincing words, Bob Geldof told conference that HIV/AIDS is perceived as a problem for “junkies, gays, hookers and Africans” and urged delegates to berate those who reveal their prejudices by blaming HIV/AIDS on lifestyle choices.

Such attitudes ensure people living with HIV continue to be shunned by families, friends, their community, and the wider
population. This in turn leaves people living with HIV grappling with feelings of shame, and low self-esteem. But the rippling
effects of stigma are more far-reaching than that: stigma facilitates the spread of the disease.

Because of stigma, people are reticent to get tested. "People are sick," said Michael Kirby, AIDS campaigner and conference
speaker, "the best thing is to get people onto care and that means getting them to get the test and they won't take the test if they’re ashamed of themselves or frightened of the stigma." An unwillingness to get tested means people are ignorant of their status and therefore likely to infect others. These people are often diagnosed when the virus has progressed to AIDS. This makes treatment less effective and causes early death.

Because of stigma, people with HIV hide or ignore their status, and refuse treatment. This makes them more infectious, putting their health and the health of their sexual partners at risk. Those most vulnerable to HIV — gay men, sex workers, injecting drug users — are the most stigmatised. They’re driven underground, far removed from essential treatment and services.

“Too many people are afraid to see a doctor to determine whether they have the disease or to seek treatment,” said UN
Secretary-General Ban Ki-moon. “[Stigma] helps make AIDS the silent killer, because people fear the social disgrace of speaking about it, or taking easily available precautions. Stigma is a chief reason why the AIDS epidemic continues to devastate societies around the world.”

According to UNAIDS, efforts to combat stigma and discrimination are essential in halting and reversing HIV. “Advancing human rights and gender equality” are “strategic pillars” in the global response to the epidemic. A UNAIDS report states more than two out of three of the 35 million PLHIV are in sub-Saharan Africa. Stigma is among the number one reasons why PLHIV are being left behind within the region. Often, the stigma stems from religious extremism. 

Many African countries — such as Nigeria, Zambia, Zimbabwe and Uganda — have embraced a hard-right Christian
rhetoric. Governments and evangelists preach that homosexuality, prostitution and promiscuity are sins. HIV/AIDS is God’s retribution. Rather than offered help, PLHIV are condemned to Hell.

On a national level, anti-gay laws further prevent those at risk of HIV seeking help. Last year, a UNAIDS study found that 78
countries worldwide listed homosexuality as a crime. A study from Nigeria — a country that mandates ten-year prison terms
for anyone promoting homosexuality, including HIV/AIDS workers — found people who are criminalised and stigmatised are more likely to lack education, treatment and services, and therefore more likely to transmit HIV. 

“We need to shout out loud that we will not stand idly by when governments, in violation of all human rights principles, are enforcing monstrous laws,” said conference chair, Françoise Barré-Sinoussi, at the AIDS 2014 opening ceremony.

Such stigmatising laws are now, largely, a thing of the past in Australia — but if you think we’re more enlightened when it comes to PLHIV ,think again. Although 2014, sadly — understandably — an HIV-positive person is unlikely to disclose their status at their workplace for fear of social isolation; parents of positive children keep silent to friends and relatives; upon disclosing their status to sexual partners many PLHIV experience kneejerk, panicked reactions; gay men on Grindr stipulate hook-ups “must be DDF” — drug and disease free (i.e. HIV).

To help tackle this stigma Queensland Positive People has launched a video campaign called ‘Stuck in the ’80s’. The campaign aims to break the ignorance still surrounding HIV. It reassures people, for instance, that HIV can’t be caught from a communal coffee mug. But surely no-one thinks that anymore. We’ve moved on from sterilising toilet seats, right? Seems not.

A survey from the HIV Foundation has found that one-in- six Queenslanders think you can get HIV from sharing a drink, or a kiss. “I thought I’d picked up a report from 20 or 30 years ago,” said HIV Foundation chief executive Tony Majer.

The survey also found that 47% of respondents would not welcome someone with HIV into their family; 46% would not want
someone with HIV looking after their children; and 42% would not share a unit with someone with HIV. Much like the “Grim
Reaper”, or Kajagoogoo, isn’t it time such prejudices were left back in the '80s?