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omparing the Manifestations of HIV/AIDS (US vs South Africa)

In the United States specifically where we are resource rich, the stigma of having HIV has changed and manifested greatly over the years. Initially we blamed, stigmatized, and ostracized the entire at the time most referred to the group as the homosexual or gay community. People associated and attributed anything that had to do with the spread of the disease with them, with the small exceptions of other risky sexual practices and poorly processed blood transfusions. People were dying. They were frail and sores were probably most notable. You knew who was infected because you knew where the clinics were located, and you knew if they had medications because they would leave with brown bags. Privacy was almost non- existent and so was disclosure among partners. This caused great fear in the community. Fear of stigma and discrimination can also inhibit health seeking behavior and is a major obstacle for timely diagnosis, prevention efforts and linkage to care and support (Andersson et al, 2020).   Fast forward to today and you barely hear of any infections and the rates have lowered.  People are now living active lives with the HIV virus. Commercials are in rotation with members of the LBGTQIA representing prevention and education of all diseases. No one is a secret, and your health is private. Disclosure is major.

In a country such as South Africa, where resources are limited, the stigma of HIV seems different. I work there several times of the year where we transport medications and medical supplies to the clinics. I know they are afraid, but there is a level of acceptance that is present in the communities there.  In the beginning it was widespread and an epidemic (although it later became a pandemic for the continent). We clearly saw the affects of the disease and the death rates rising daily. The country was not able to provide medical care and medications to keep up with the amount of people needing them.  Fast forward, and now it’s almost taboo. No one seems to be afraid so much as they are just dealing with it. The women are afraid to ask their husbands to wear condoms even though they know they are sleeping around. People have accepted that HIV is “a thing” and that people have it. Nothing is private. They are educated and are now provided resources from supporting countries yet; the rates of infection continue to rise. Life is going on and people are not dying, depressed or sickly looking. Approaching an HIV clinic does not have the same traumatic affects that I remember seeing when working at clinics here in the states.  The diagnosis is no longer a death sentence.

Even with all the changes and strides we’ve made in America; we still have a long way to go. The discrimination is just not as loud anymore, but it’s still there. According to Andersson et al (2020), HIV associated stigma remains a major human rights challenge and addressing HIV-related stigma and discrimination will be necessary to achieve the goal of ending AIDS as a public health threat by 2030.

References

Andersson, G. Z., Reinius, M., Eriksson, L. E., Svedhem, V., Esfahani, F. M., Deuba, K., Rao, D., Lyatuu, G. W., Giovenco, D., & Ekström, A. M. (2020). Stigma reduction interventions in people living with HIV to improve health-related quality of life. The Lancet HIV, 7(2). https://doi.org/10.1016/s2352-3018(19)30343-1