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Stigma(ta) AIDS Review 2007 offers a comprehensive overview of HIV and AIDS-related stigma and why it remains so pervasive in all societies. The strength of HIV and AIDS stigma challenges many of the beliefs people have held about AIDS and stigma. These beliefs were that as more people were living with HIV then stigma would reduce; that the more people were open about their HIV status and disclosed this to other people that stigma would drop; that high levels of death in a community and society would cause stigma to reduce; that testing and treatments would reduce stigma so that HIV and AIDS would become another chronic, treatable medical condition, and that stigma would cease to be such an issue.
Except in a few individual cases, some communities and a couple of countries, these beliefs have not been borne out. Although one can give many cases where stigma has been reduced, where personal agency has been powerful and where people have been supported by friends and family, there are still many stories of death, discrimination, prejudice and suffering brought on by HIV and AIDS stigma.
Stigma has accompanied HIV and AIDS since the first moment the virus was identified, named and brought to the public’s attention through media reports and education and prevention campaigns. The roots of this stigma are well researched. Many people believe that they lie in the ways in which societies do or don’t deal with issues of sex and death. Does HIV and AIDS stigma develop because death is linked to very intense, personal sexual behaviour usually associated with pleasure and life? Does stigma develop because in many societies sexual language is limited and there are no easy ways to talk about desire, sexual preference, sexual loneliness and longing? Does stigma develop because HIV has laid bare social hypocrisy and sexual dishonesty? Before HIV and AIDS it was possible to mask sexual behaviour that went beyond the norms of society – with AIDS the social sexual behaviour either ignored or hidden was exposed. People were confronted both with the possibility of infection and death, but also with having to disclose sexual patterns of behaviour that possibly flouted social norms and conventions. Instead of interrogating sexual dishonesty and seeing how social interactions were constructed and developed, the onus fell on people living with HIV to carry the full weight of infection and behaviour. The halting of the epidemic was placed at the door of people who were already infected – they were to change sexual behaviour, they were to test and disclose and they were to be responsible. When they failed, the rest were able to find easy and convenient scapegoats for the behaviour and dishonesty of the remainder of society.
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