I would venture a guess that, for those who undergo routine STI testing, it is not uncommon to play the “What if” game — “What if I have an STI (be it gonorrhea, chlamydia, whatever)?”
The answer to that question is pretty simple for most sexually transmitted infections: You get on antibiotics for three to seven days, clear up the problem and hopefully learn a lesson regarding unsafe sexual practices. But for many men who have sex with men (MSM), the “What if” game includes the question “What if I am HIV positive?” A week’s worth of antibiotics certainly is not the answer.
Tyler Curry, senior editor at HIV Equal Online, confronted this reality when he unexpectedly received a positive diagnosis. “Trying to hide your status is like being in the closet again,” he told me. “Now, it was a much smaller closet to wrestle with given that the population of HIV-positive people is smaller, but it was still a new type of closet.” The problem with smaller spaces, though, is that they more frequently induce claustrophobia. A positive HIV diagnosis can be isolating.
Achieving viral suppression requires summoning the courage to get tested and then adhering rigorously to a prescription drug regimen for life. Imminent death is no longer the certain result of HIV. But while the virus has transitioned from “plague” status in the eighties and nineties to a chronic and manageable illness today, we as a society have struggled to catch up in terms of how we perceive the virus.
Fear about how individuals will react at home, discrimination in the workplace, the implications for a future love life and concern for one’s own personal wellbeing are completely understandable responses for a person with HIV.
Still, regardless of how much we empathize with these concerns, a counterproductive tendency exists in both the gay and straight communities. Most of us feel that only those who are HIV positive need to understand the virus, which results in condemnation out of misplaced fear. And, as Curry notes, this can lead people to try to “escape” a positive diagnosis through purposely avoiding testing or hiding their own status from those closest to them.
Despite the presence of antiretroviral drugs (ARTs) on the market for nearly two decades, 44 percent of Americans believe that treatment does nothing to help prevent the spread of HIV. And while the portion of Americans who report knowing someone who died of AIDS or currently has HIV has increased in recent years, only about half of people surveyed in a 2012 study from the Kaiser Foundation report being “very comfortable” working with someone who has HIV or AIDS.
To point out what might seem obvious to some but nevertheless eludes others, unless you are having unprotected sex or sharing needles with someone who is HIV positive, you are not at risk for contraction. Either the workplace is a lot more interesting than I previously thought, or ignorance is a major culprit in the “othering” of HIV-positive individuals.
Misinformation and stigma propagate themselves in many different forms. Regardless of how stigma presents itself, though, we must make a conscious effort to root it out.
Efforts to fight stigmas come in many forms. The easiest place to begin is a linguistic adjustment. Stop describing yourself as “clean” when you talk about your own status. You are either “negative” or “positive,” and “positive” does not always mean the virus is transmittable.
Reforms to the judicial system prove a little less accessible to the general public. At least 33 states currently have laws related to exposure and/or transmission of HIV, and five states lack state laws but are on record as prosecuting individuals on HIV-related grounds. Some of these laws are genuinely rooted in preventing the malicious and purposeful spread of HIV, but many are not.
Take for example Texas, which in 2008 convicted a homeless man of assault with a deadly weapon after spitting on a police officer while HIV positive. The CDC has no record of HIV transmission via saliva. Many states have similarly uninformed statutes, prescribing harsher sentences for HIV-positive people when there is no risk of transmission. These laws should have no place in our country.
Last, we must make every effort to inform the public about the realities of HIV. This is, of course, difficult given our historical predisposition to condemn sex between men. Nevertheless, it is a prerequisite to crafting a society that confronts HIV rather than runs away from it. We must incorporate information on HIV among MSM into our sexual education programs.
We can begin to defeat stigma today. As an exercise, play a modified version of the “What if” game: What if your brother or best friend received a positive diagnosis? Would your response be constructive or destructive? If you think it would be destructive, revisit what you know about HIV and make some necessary changes.
In the fight against the HIV epidemic in America, anything that encourages people not to seek regular testing or to hide their status must go, including our fears and unawareness.
