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to Section One | to Arts & Entertainment
posted Friday, March 14 2014 - Volume 42 Issue 11
HIV and stigma in 2014
Section One
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HIV and stigma in 2014

by Ron Anders - SGN Contributing Writer

By 2014, one might think that the stigma and shame attached to an HIV-positive diagnosis would be greatly diminished. After all, the epidemic, which started in the early 1980s, is now over 30 years down the line. For many people with HIV today, symptoms can be managed similarly to other chronic illnesses. HIV treatment was transformed with the introduction of the first protease inhibitors in 1996 and recent polls show that most Americans no longer consider AIDS to be a major public health issue. This assumption, however, does a great disservice to people living with HIV. People are still dying of AIDS and, while infection rates are stable, they are still alarmingly high. In my psychotherapy practice, I have treated many individuals who struggle with the stigma of HIV and the concomitant challenges of depression and isolation.

Historically, there have been many diseases which stigmatized particular minorities as carriers. African-Americans have long been stigmatized as carriers of sickle cell anemia. As a result, during World War II, the American Red Cross practiced racial segregation of blood plasma, not unlike the ongoing prohibition of blood donations by Gay men. Outbreaks of the bubonic plague in Europe were often blamed on Jews. This stigmatization is glaringly apparent when discussing Gay men and HIV. Emerging only 11 years after Stonewall, AIDS is a relatively new disease. Fear surrounding the surfacing epidemic in the 1980s is still fresh in many people's minds.

The continuing stigma of HIV/AIDS can lead to self-defeating behaviors in some Gay men. One of these behaviors consists of self-shaming, feeling that they 'should have known better' than to get infected with a disease whose mode of transmission is well known, unlike early in the epidemic when transmission paths were unknown. Even those men with a large network of friends can feel isolated because they refrain from mentioning their HIV status to others. They often say that they feel 'alone in a crowd.' HIV-positive men whose status is unknown by others sometimes report that their friends have made disparaging remarks about men who they have heard are HIV-positive. They report feeling intensely conflicted and alienated. It reinforces their fear that they have much to lose by revealing their status.

Many HIV-positive Gay men whom I have treated report that they avoid dating, not wanting to repeatedly have 'the talk' (revealing their HIV status) with a potential partner. Having a date 'disappear' after the disclosure is a common experience, one that can gradually erode feelings of self-worth. Multiple rejections can diminish their willingness to reach out to others. Some men report that they feel like 'damaged goods,' which can lead to feelings of loneliness and isolation, often manifesting as depression. They feel defined by their HIV status often losing track of their intrinsic worth and appeal.

To help resolve the isolation caused by feeling stigmatized, it is crucial to look for support in the community. Talking with others who have tested positive for HIV/AIDS can be hugely helpful in normalizing the spectrum of emotions that are brought on by a diagnosis. This can be done on an individual or group basis. Seattle organizations such as Gay City and the Seattle AIDS Support Group, among others, provide a wide variety of services for people with HIV concerns. Some social groups, like POZSeattle, hold events specifically for HIV-positive men. Organizations such as meetup.com also offer forums for discussion.

An HIV diagnosis is a serious and challenging issue. Its accompanying stigma often precipitates a feeling of being out of control - emotionally and physically. It is crucial to develop coping skills that foster a feeling of equilibrium. These may consist of acknowledging the diagnosis and, simultaneously, choosing to move forward with one's life. For some, these two steps may initially feel incompatible. However, working on one's own or with the help of a therapist, support group or friends can go a long way in integrating the tasks facing those newly diagnosed with HIV.

Ron Anders, LICSW is a psychotherapist in private practice in Seattle. He can be contacted through his website: ronanders.com.

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