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Ignorance Breeds AIDS/HIV Bias
By Christina Schulthoff, Medill News Service
WASHINGTON - Health care workers are fired, patients are denied dental care, little girls are kicked out of the Girl Scouts and people are routinely denied health insurance. All this is happening to people who have one thing in common: they are all HIV-positive.
For the victims of a global epidemic, "stigma is still alive and well," observes Catherine Hanssens, director of the AIDS project at Lambda Legal, a national organization fighting for the civil rights of lesbians, gay men, transsexuals and people with HIV/AIDS. After more than 20 years of dealing with AIDS and its repercussions in America, discrimination still abounds. The root of that discrimination, asserts Hanssens, is ignorance -- "Fear rather than fact."
Daniel Bruner, associate director for litigation at the Whitman Walker Clinic in Washington, a community-based health organization for people with AIDS and HIV, agrees.
"The level of misconception is still very high," he says.
According to a study by the American Journal of Public Health, he's right. The study found that a growing number of Americans don't understand how AIDS is contracted. A similar study on HIV-related knowledge and stigma conducted by the Centers for Disease Control and Prevention in 2000 found that more than 40 percent of respondents believed, incorrectly, that HIV transmission could occur through the sharing of a glass. Forty-one percent believed that it could occur from being coughed on or sneezed on by an HIV-infected person, and almost 19 percent said that people who acquired AIDS through sex or drug use have gotten what they deserve.
As a result, Bruner now has to deal with cases involving HIV-positive food service workers being fired because employers fear the workers might contaminate food and spread the disease. Common misconceptions, Bruner points out, lead directly to the widespread discrimination that victims must face every day.
Not surprisingly, examples of discrimination are everywhere. Alongside the food service workers, Bruner is currently helping a client who was fired from his job as a construction worker because he is HIV-positive. When he told his boss at the construction company that he had contracted the disease after being pricked by a contaminated needle in a garbage bag he was carrying at a previous job, he was informed he had to leave. One of Hanssens 's recent cases involved representing a family whose Pennsylvania county refused to place foster children in their home because they have a foster child with AIDS. The county saw the HIV-positive child as danger to any other children's health.
Discrimination is doubly difficult when HIV status comes along with a host of other troubles, says Patricia Wudell, director of Joseph's House, a home for mostly African American homeless men with AIDS. "The stigma that these men deal with is that they are African American, poor, homeless and sick…. I know that [they] fear discrimination because of AIDS."
HIV-positive women also experience stigma and discrimination. According to Cathy Christ at the Chicago Women's AIDS Project, many women are afraid to even talk about their illness, so they don't realize that they are not alone. "Generally, women are still very careful about the consequences of disclosure" as they fear the reactions of family members and friends, she said.
Christ says that they also fear losing their jobs if they disclose their illness and end up not seeking medical treatment.
But what can be done when ignorance breeds discrimination, and that discrimination breeds a desire not to get tested? Hanssens and Bruner agree that education is the key.
Hanssens emphasizes how important sexual education and prevention campaigns are in schools. "It's important to realize that the epidemic is very serious among young people right now."
Bruner concurs that sexual education is essential, and he pointedly criticizes sex education programs that only teach abstinence. Bruner says telling teens to "simply say no" just doesn't cut it. He also notes that the notion of abstaining until marriage is especially meaningless to the gay and lesbian community because same-sex marriages are illegal in the United States. In the face of such criticism, the Bush administration has nevertheless proposed an increase in federal support for abstinence-only programs from the current $100 million to $133 million.
Without education to teach them otherwise, many stigmatize AIDS as a "junkies' disease" or a "gay plague," creating a false sense of security among those not considered at high risk. Experts say this could be partially responsible for the current plateau in the rate of new HIV infections at 40,000 cases a year, which had dropped 47 percent from 1996 to 1998. Even though rates are still highest for men who have sex with men and people using injection drugs, numbers are on the rise for women and heterosexual men, populations once thought removed from the virus and its dangers. According to the Centers for Disease Control and Prevention (CDC), one in four people don't know they are infected. That percentage increases for minorities, say experts, because they are not reached by traditional awareness campaigns and many are not accustomed to seeking preventive medical care.
Currently, 500,000 Americans are infected with the disease and 20,000 died of AIDS in 2001, according to UNAIDS. The CDC says that about half of the infected people in the U.S. are not receiving treatment, often because they don't know they are infected.
Meanwhile, the UN released a study this month that predicts 70 million will die worldwide of AIDS by 2022 unless there is a marked increase in prevention and treatment. Although the government has recently increased HIV and AIDS funding, experts say that many deaths could be prevented if stigma were reduced and people were better educated about the prevention of HIV.
"HIV and AIDS are as much about social phenomena as they are about biological and medical concerns," declares the international AIDS education and research charity Avert.
For now, Catherine Hanssens and Daniel Bruner will continue to fight for the rights of HIV-positive victims of discrimination, and Bruner doesn't see the problem going away any time soon.
"We are finding that discrimination is an ongoing issue for our clients," he affirms. "We get new complaints from people with AIDS or HIV every single week."
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