Tricia's Partial Mutterings

AIDS in America

AIDS was first identified as a disease in America in 1981, and since then the epidemic has not stopped growing. Today, in 2005, most Americans know that AIDS threatens millions of lives around the world, and that many people in developing countries are dying because they can't access the drugs they desperately need. American leaders talk about the desperate need to help other countries, which leads people to believe that HIV is something that happens in these other countries, and to other people. But while it saves lives in Africa, is the US government ignoring problems at home?

In spite of the large numbers of deaths which have already occurred in America, and in spite of the even larger numbers of Americans who are now living with HIV or AIDS, the media-led complacency continues. Many people in the USA continue to think that AIDS is something which could never happen to them, and many people in the USA continue to become infected. Debate continues about how best to deal with the American epidemic.

Issues - discrimination

Discrimination is something which happens all over the world, and America is no exception. Since the beginning of the epidemic, HIV+ people have experienced stigma, stereotyping, and discrimination - sometimes leading to violence, always distressing. In the early days of the epidemic, this discrimination occurred due to the tendency of people to fear what they don't understand - and there was a lack of understanding about what caused AIDS and how people could become infected.

As early as 1983, police officers in San Francisco wore special masks and gloves for use when dealing with a 'suspected AIDS patient'. They were concerned that they could bring the bug home and their whole family could get AIDS. At the same time landlords evicted tenants who had AIDS, and in 1985 Ryan White, a 13-year old schoolboy who had become infected via a blood transfusion, was banned from going to school, in case the other children "might pick up AIDS".

A Florida family called the Rays had three sons who were each HIV+, haemophiliacs who contracted the virus from infected blood products. In 1986, the family were told that their sons were not to attend the local school. They moved to Alabama, where the same thing happened. The family began to be threatened, and eventually the Rays' small single-storey house was doused with gasoline and torched.

Such violence is clearly the result of an extreme and unacceptable level of discrimination. The United States now has legislation which makes it illegal to discriminate against someone on the basis of their HIV status, and as early as 1986 the government made clear to employers that they would be prosecuted if they discriminated against HIV+ people. In spite of this, discrimination is something which still occurs today, and although it may not involve physical violence, it can still have traumatic consequences for HIV+ people.

Reasons for discrimination

This sort of discrimination is often a result of ignorance - the general public didn't understand AIDS, didn't know how it was transmitted, and didn't know they weren't at risk from everyday contact with infected people. Those in authority, those who were seen as setting an example of how to behave, were just as ignorant, and when the public saw police and school officials acting in this way, alarm increased. Given that discrimination is often a direct result of ignorance, this suggests that AIDS education was, and maybe still is, either not working or not present at all.

America, however, started early in educating its public about AIDS - the first national AIDS awareness campaign came in 1986, and since then there have been more campaigns to educate the general public and specific risk groups. Clearly, however, not enough is being done, as discrimination continues. Issues surrounding AIDS education in America are examined later in this page.

Another reason for the discrimination experienced in America by people who are HIV+ is the existing prejudices against the most-affected groups. Long before AIDS was an issue, gay people, injecting drug users, sex workers all experienced considerable hostility from society. AIDS, of course, has provided another excuse for this prejudice. It seems that a large proportion of the American public still associate HIV with injecting drug users and gay men, and see it as something 'dirty', even as something which HIV+ people 'brought on themselves'.

To some extent, this is exacerbated by HIV+ people themselves and by the media who talk about the 'innocent victims' of the AIDS epidemic - meaning babies infected via mother-to-child-transmission, or people infected by blood transfusions. This concept of 'innocent victims' implies a concept of 'guilty victims' - people who were infected via risky sexual behaviour, or injecting drugs. Of course, no-one deserves to die for taking drugs or having sex, but the terminology suggests otherwise. In turn, this increases the stigma directed towards many HIV+ people, who are seen as being to blame for their infection

Aside from the distress it causes to those who experience it, discrimination against HIV+ people has several other negative consequences.

Results of discrimination

In a situation where people who are HIV+ are discriminated against, anyone who has a positive test result will be very reluctant to 'come out' about their status. The more people who are open about their HIV status, the more the general public will be aware that there is an ongoing problem, that people do continue to become infected, and that they need to protect themselves. They will also be able to see that HIV+ people are not exclusively gay men or drug users, which will itself help to fight prejudice. Furthermore, if there are already plenty of people who are 'out' about their HIV status, this makes it easier for someone new to 'come out'.

Another negative effect of social discrimination is an increase in people's reluctance to learn their HIV status. People generally don't want to join a group which is stigmatized. Of all HIV infections diagnosed in 2002, 38% progressed to AIDS within 12 months after HIV infection was diagnosed.24 This high percentage suggests that many HIV+ Americans had been infected for a number of years before they were tested - during which time they may have infected other people. Reluctance to learn their status and thus join a stigmatized group might explain this gap between infection and testing.

Solutions to discrimination

In the early days of the AIDS epidemic in America, very few well-known people 'came out' as having AIDS. Since then, some people have been open about their HIV status, something which helped to show the public that the disease was something that could happen to anyone, and that people with AIDS weren't necessarily gay men or needle users. This helped to reduce the discrimination felt by HIV+ people across America. Still, however, few straight people have 'come out' as being HIV+, and there remains a lack of HIV+ 'role models'.

Another solution to discrimination is to teach people how they can protect themselves and how they can become infected - so they know that there is no need to fear HIV+ people. For this discrimination to be dissipated, however, an effective AIDS education program is required.

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Posted by tricia at October 30, 2005 10:23 PM