Concentrated epidemics, generalized stigmas

To date, most Latin American countries have adult HIV prevalence under 1%, which places them within the group “Countries with Concentrated Epidemics”; hence, they are focusing their responses on delivering actions to the most affected or most vulnerable populations so as to halt the spread of HIV and to reverse its impact.

As such, some of the programs underway are peer counseling for men who have sex with other men (this includes the trans population) and for sex workers, screening for pregnant women as a way of reducing the probability of vertical transmission, hypodermic needle-exchanging, and others. These have, sadly, consumed a large part of available HIV response funds, so much so that little has been done to conduct large scale awareness raising, prevention, and stigma and discrimination reduction campaigns.

You may be wondering how someone can dare say such a thing.

A few days ago, we struck up a conversation with an elderly gentleman, who, by his manner of speech and dress seemed to be college educated and to have some money. For an unknown reason, I made the comment that I had just attended a meeting whose topic was responding to HIV. Something he said really caught my attention: “And, aren’t you afraid that you are going to get infected? Because being in the same room with those people is how you get the disease.” We really wanted to believe he was joking, but his body language and his subsequent comments shook us back to reality. We had a brief, quick chat with him, trying to bring him up to speed on the facts, but we left unconvinced.  

This story is now branded on our minds. But there is more… we are furthermore shocked every time we hear someone say they were fired from work, the doctor would not see them, or they can no longer have sex, procreate, or get married because they are HIV positive or their children are not allowed to attend school because people found out they are living with HIV. And this is taking place in Latin America where countries are experiencing concentrated epidemics.

The issue at hand is that since we place such an emphasis on strategies that respond to specific populations in an effort to stop the spread of the epidemic, we lose sight of the fact that society generalizes HIV related stigma and discrimination.

Accordingly, we dare suggest placing more attention on that “general population”, one which is, perhaps, not comprised of gay men, trans people, sex workers, or illegal drug users, or other minority groups, but is the majority that does live with these people, and should know about the epidemic, how it is and is not transmitted, and how to combat the stigmatization and discrimination of people who are living with HIV and AIDS.

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