Monday, April 12, 2010

HIV Stigma and Discrimination

A Report on a National Dialogue on HIV/AIDS

“There can be no true progress without stigma reduction.  Stigma is still the REAL reason so many don’t want to know their status, don’t get help, or are afraid to be
advocates for their own health.” —Hammond, Indiana Web submission

HIV discrimination and stigma were common topics across community discussions. Many expressed frustration over the pervasiveness of HIV stigma nearly 30 years into the HIV epidemic. Studies have shown that HIV stigma is related to delayed HIV testing and care, as well as disclosure to family and
friends. People living with HIV can experience violence, rejection, and even eviction from their homes because of their serostatus, and HIV-positive persons continue to report discrimination in employment and health care settings.(109)

A New York City woman discussed her inability to find a dentist who would treat her because she is HIV positive. A Jackson, Mississippi woman talked about being advised by her provider to have an abortion, merely because she was pregnant and HIV positive. A Florida man complained, “I have been refused
treatment…. by medical doctors for my HIV on several counts while covered by private insurance...  Imagine a world in which medical doctors do not refuse …life saving services to people with HIV/AIDS.
Is that too much to ask?” 

A few community discussion participants simply asked for existing anti-discriminatory policies to be enforced. For instance, the Federal AIDS Policy Partnership sug- gested, “Issue an Executive Order that requires all Federal agencies [and their contractors] comply with the Rehabilitation Act by barring them specifically from
using HIV infection as a basis for categorical exclusion.” Participants also discussed the importance of adhering to the Health Insurance Portability and Accountability Act (HIPAA) Privacy Rule to protect personal health information. “Congress should establish stricter penalties for violating HIPAA protections that result in loss of  employment, health care coverage, or breech of privacy,” stated a New York organization.

Enforcement of the Americans with Disabilities Act was similarly highlighted. A San Francisco man who is deaf defended his civil rights under the Americans with Disabilities Act to have access to auxiliary aids and services for effective communication. “I go to school,” he noted, “[but the] school does not provide interpreters. When I go to work, they do not provide interpreting service. It is hard to get an interpreter, but we really need it for medical care to be able to speak, to go to a hospital, to get medical needs met.” Discrimination against sexual minorities was mentioned in several community discussions. We heard from those who expressed frustration over the lack of recognition of same sex relationships in visitation policies or insurance coverage. The commonality across each of these comments is that stigma and discrimination continue to pose significant barriers to those infected or affected by HIV, and the NHAS must address these issues to be successful.

109.  Herek, G.M., Capitanio, J.P., Widaman, K.F. (2002).
HIV-related stigma and knowledge in the United States:
prevalence and trends, 1991-1999. American Journal of Public Health, 92(3), 371.

Posted via email from Reggie Smith's Posterous by SocialNetGate

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