Those of us working in HIV prevention have always believed that the spread of the virus was largely due to stigma around sex and sexuality, and that the only time we’d see any sort of progress in the fight against the epidemic, was when society started engaging on the matter more openly. But, it wasn’t until the 2009 report on the correlation between the spread of HIV and stigma in the Dominican Republic that we could claim it as a fact.The implications of this report illustrated how social attitudes create an environment that propels the spread of HIV. Researchers found that stigma affected treatment toward people living with HIV; this has consequences for access to sexual health services and the way they are administered by health professionals, or, in some cases, denied. Researchers also found that stigma consequently affected at-risk individuals’ willingness to seek HIV-related services, including testing. Stigma, therefore, helps to drive the spread of this virus.
This is evident when observing the prevalence of HIV among African-American women in the United States (U.S.). According to the Centers for Disease Control and Prevention (CDC), of all women diagnosed with HIV in 2014, most new infections were attributed to heterosexual sex and an estimated 62 percent of women diagnosed were African-American.
CDC attributes this trend to the fact that “the greater number of people living with HIV (prevalence) in African-American and Hispanic/Latino communities and the fact that people tend to have sex with partners of the same race/ethnicity.” New infections among injectable drug users, both men and women, were relatively low.
This implies that, somewhere along the line, the men these women are having heterosexual sex with are also having unprotected sex with other men; because, if prevalence among African-Americans increases the risk of HIV among Black women, and Black men who sleep with men remain most affected by the virus, then one can assume that some heterosexual men are also sleeping with other men.
While the LGBTQ community has made massive legal strides in the U.S., in recent years, religious condemnation of same-sex relationships remains widespread. Religion continues to be a cornerstone in the the African American community; it played a significant role in the liberation of Black people. Faith-based leaders often site the spread of HIV among the greater African-American population to support anti-gay rhetoric.
Misinformation breeds stigma, creating an environment where people are afraid to engage the matter beyond the pulpit. The fact of the matter is, according to a 2005 study, sex with a partner who had a history of incarceration was a key driver of HIV infections among newly diagnosed African-American women. Infection among inmates in prisons is more than five times greater than the rate among people who are not incarcerated, according to the CDC. Yet, HIV-prevention interventions in prisons are limited to testing and treatment.
Those of us who believe that stigma around sex and sexuality drive the spread of HIV are right; that’s what the facts show. Even with facts staring us in the face, we continue to let hysterics dictate our response to the pandemic.
February 7 is National Black HIV/AIDS Awareness Day.
Angelo C Louw is the Advocacy Officer at Studies in Poverty and Inequality Institute (SPII) and former HIV prevention campaigner at loveLife, South Africa’s largest youth HIV intervention. He is currently a Fulbright/Hubert H. Humphrey Fellow based at the University of Maryland. He writes in his personal capacity.
PHOTO CAPTION: Angelo Louw says that stigma helps to drive the spread of HIV in the Black community.
