Which is the real disease: HIV or stigma?

Stigma is one of the most prominent barriers to HIV prevention, treatment, care and support.  Even though HIV is a virus, it could be argued that stigma is the disease. Stigma causes issues that make the effects of HIV worse. There are many reasons why this could be the case.

Stigma may cause people with HIV to end up being isolated within their homes, in public or at workplaces. Sadly this stigma also exists in healthcare, as it limits those with the virus’s access to HIV prevention.  A person can be prevented from being honest to healthcare workers when they seek medical help and fear being stigmatised or that their confidentiality will be breached.

Stigma and discrimination can serve to destabilise global efforts to prevent the spread of HIV and AIDS. It can lead to offshoots, such as harassment and abuse, poor health services, access and uptake and violence. This can cause a person to be marginalised, which is turn can lead to poor social or emotional wellbeing or poverty, which serves to worsen the individual’s issues.  In some areas, discriminatory policies and laws may increase the risk of HIV infection.

One study (Sayles et al, 2009) found that participants who reported high amounts of stigma were over four times more likely to describe poor access to care. This is a contributory factor to the growth of the global HIV epidemic and the higher number of AIDS- related deaths. In another study of patients in Botswana (2006), a majority of those reported deferring HIV testing did so due to the stigma surrounding HIV and AIDS.

Additionally HIV- related stigma affects people’s ability to earn a living, making it even more difficult for people living with HIV to lift themselves out of poverty. Therefore, they remain trapped in a vicious cycle.

So which is the disease- HIV or its stigma? From the sounds of its, stigma can be just as big an issue as the virus it surrounds. When we start to tackle this stigma, then we make big advances in dealing with HIV issues.