American Society Essay, Research Paper
How Have AIDS Victims Been Stigmatized by American Society?
The purpose of this essay is to awaken the sleeping community, house-by-house, room-by-room, and person-by-person to the issues of bigotry, discrimination and racism surrounding this stigmatization; and, to enlist the resources available to our society to help these victims rather than condemn them.
The definition of stigma according to an excerpt from The American Heritage Dictionary of the English Language is “a mark or token of infamy, disgrace, or reproach.” The archaic definition, “a mark burned into the skin of a criminal or slave; a brand” leaves little doubt that a stigma like AIDS is a double-edged sword, a brand of its own. This simple description expresses society’s inability to deal with HIV and AIDS and most specifically the transmission of the disease throughout the American culture via the innocent and the damned. Just as this definition suggests that a stigma is disgraceful and a moral mark or brand, the promotion by the homophobic white male of the myths, misconceptions and ignorant philosophical views surrounding the stigmatization of AIDS victims must be eliminated through education and exposure of the misinformation. To clarify further the distinction between HIV and AIDS victims, it is important to understand the medical difference between them. HIV indicates that the individual has contracted the AIDS virus, Human Immunodeficiency Virus, and AIDS indicates that the person has developed the full spectrum of the disease, AIDS, Acquired Immune Deficiency Syndrome.
The victims of AIDS are socially excluded in the following areas: “1) pose a threat to others health or safety (by being dangerous, reckless or contagious); 2) deviate excessively from group standards by violating morals, rules and norms; 3) fail to contribute adequately to the welfare of other individuals or the social groups to which they belong because they are perceived to be incompetent, irresponsible, infirm or selfish; 4) create negative emotional reactions in others by being socially adverse, aesthetically displeasing or emotionally threatening” (Derlega 15).
1. In our society, people tend to avoid those who pose a potential threat to their health and safety. This is caused by the fact that AIDS is contagious, fatal and presently incurable. The majority of the public still hesitates to interact with individuals with AIDS despite reassurance by the medical community that HIV is not transmitted by casual contact (Derlega 16). As hard as this is to believe, family members of HIV and AIDS victims may also experience this trauma in the same manner. Many people are doubly stigmatized if they are known to have transmitted the virus to another person for example women to their unborn children or gay men to their partners (Derlega 20).
2. The general populace is less accepting of those who deviate from the publicly accepted norms, morals and values than it is of those who conform to those social standards. One aspect of the AIDS related stigma is linked with life styles that may be regarded as deviant if not morally wrong. “Thus not only is the disease itself stigmatized because of its perceived threat, it is associated with groups that were already stigmatized before the outbreak of AIDS such as gays, intravenous (I.V.) drug users, and to a lesser extent certain minority groups (Derlega 17). Not all victims of AIDS are as stigmatized by the groups to which they are related, such as the innocent and blameless children or victims of an infected blood transfusion. This shows that others in essence acquired the disease through behavior that is perceived as deviant, or morally wrong.
3. Social groups place considerable emphasis on members carrying their weight. Those who cannot or will not do their share are less fully accepted as full fledged social participants. People with HIV and AIDS often cannot meet their occupational, family and social obligations as fully as they did before they were infected. Many tire easily, must work less for medical reasons and during later stages of the disease require assistance from other people (Derlega 18). Whether physical limitations are real or imagined by others, people who are HIV positive may be viewed as peripheral social contributors who drain more emotional, financial, and practical resources from others than they contribute.
4. People also disassociate from those who lead them to experience adverse emotions. “From a simple operant perspective we are punished for interacting with people who regularly make us feel afraid, angry, repulsed, depressed, or otherwise uncomfortable” (Derlega 19). Such a reaction is understandable but it leads us to avoid and exclude people through no fault of their own. Some writers have also suggested that dealing with the terminally ill makes people uncomfortable because it forces them to confront their own mortality. A person with obvious signs of AIDS such as: Kaposi’s sarcoma, emaciation, hair loss, or disfigurement is more likely to evoke negative reactions and is more likely to be stigmatized (Derlega 19).
“But AIDS in America more than every other Sexually Transmitted Disease (STD), has seemed to select its victims from among previously defined groups” such as minority groups stigmatized by AIDS (Nelkin 21). Those groups are described in detail in the following paragraphs to further illustrate the exclusion from the general populace by this connection.
The gay portion of our population is predominantly affected by the disease and is most frequently stereotyped as associated with the disease. “Living with HIV or AIDS may be especially challenging for gay-identified men but they also have some unique coping advantages as a result of their group membership” (Derlega 31). The gay community is more likely to offer both emotional support and tangible assistance to members of their own group. Thus gay men with HIV may experience more liking and acceptance, as well as more aid with every day needs, to the extent that the gay community is part of their identities and lives (Derlega 32). In a study interviewing ninety-two symptomatic gay men, there were two main issues of focus. The first issue was the positive consequence of gay identity and the second issue was the negative consequence of that association. The positive consequences of gay identity consist of community support, access to others with HIV, expecting the diagnosis, and the effect of a life long prejudice. “Ironically, given the resilience result just noted, all of these men felt that coping with HIV was more difficult because they were doubly stigmatized, first by being HIV and second by being gay (Derlega 41). More typically references made to the stigmas were made in general terms “because I’m gay…it’s harder. If I were straight I could be the poor innocent victim of a blood transfusion or the poor mixed up junkie…I got what I deserved as far as the straight community is concerned. People say AIDS is the gay plague and, you know, God damnation type thing…instead of saying it’s just a disease doing what diseases do—affecting everybody” (Derlega 41). This particular group additionally has the largest group of supporters financially and publicly. The most prominent people within the gay community appear to provide deeply rooted links to the cultural aspects of our society. Notably, alternative life styles and family units discourage help by the “average” community member (Altman).
AIDS is the fourth leading cause of death for women aged 25 to 44 in the United States. It is the primary cause of death in women of this same age group in nine major U.S. cities and the number of women infected by HIV is steadily increasing. The U.S. Centers for Disease Control and Prevention (CDC) reports that more than 40,700 adult women in the United States have AIDS. Experts also agree that the actual number of infected women with AIDS is even greater because many women whose immune systems are severely damaged by HIV infection remain undiagnosed and therefore unreported. The majority of these women are unfortunately Black or Hispanic further linking the stigma of AIDS not only to women but also to minority women (National Institute of Mental Health, 1998). According to my research, the use of injection drugs infected the majority of the women with HIV in our country; however, recently the number of women acquiring HIV through heterosexual contact with infected men has risen dramatically. During heterosexual contact, women are more easily infected than men when one of the partners is infected. Prostitution and forgery are the two crimes most often linked to women and are perceived by women to carry the least risk of the criminal behaviors. Unfortunately, prostitution puts women at a higher risk for HIV than forgery. As a matter of fact, prostitutes portrayed as the infectors were ignored in the beginning of the crisis as the deep rooted sexism in our society did not allow for the fact that the prostitutes were more at risk to contract AIDS from their customers than customers from the prostitutes. Through the media, the focus was directed instead to the risk to the partners and families of the customers who might be exposed to AIDS from their contact with the prostitute (Campbell). In thirteen states, excluding Nevada, laws requiring mandatory testing of women who are arrested for and convicted of prostitution are enforced. In some states, like California, the customers must also be tested, however, their arrests are far less often and not as likely as the arrests of the prostitutes, again a sexual gender bias. A second arrest for either can result in a felony charge (Campbell). Additionally, laws requiring licensed prostitutes in Nevada to get regular HIV tests were enacted and are enforced on a regular basis by inspectors. Due to the stigmatization of prostitutes in today’s society, vocational training is not readily available as a support service to a prostitute seeking an occupational change and even less available to an HIV infected prostitute with a “seropositive” status and criminal record, there is little recourse for the infected prostitute to seek other avenues of employment.
Another minority group affected is the I.V. Drug User. Statistically, more drug users are men and more research has been done on the male drug user and consequently the intravenous or injection drug user (IDU) subculture than any other group. The drug use behavior of the males IDUs is often clandestine; it is a behavior that they engage in with other men and keep secret from their female partners (Campbell). I found it interesting that IDU’s are depicted as “a dark, pathological threat” once again linking the HIV positive and AIDS victim to the dark side of the definition of stigma, the mark of infamy and reproach (Lupton 16). The female sex partners of these men are not often aware of their partners’ past or present drug use, making the majority of them at as great a risk as the female drug user. This issue affects much of the population as current research has indicated. Prostitution of men and women linked to this IDU behavior causes emotional dependency and involvement between user and user. Drug using prostitutes are four times likelier to contract AIDS and crack houses have been identified as important locations for heterosexual transmission of AIDS and other sexually transmitted diseases (STDs); crack usage also identified with the spread of AIDS among adolescents. Additionally, the minority groups are affected more “in part because of the paralyzing impact of poverty and stigma among these groups, (and) in part because there is no ‘community’ perceived as such, to bind drug users together (Nelkin 19).
Although women are a minority, the other minorities associated with this stigma are not only gender related but predisposed based on class, culture and race; even the research involving these minorities focuses again on women as perpetrators of the HIV infection. Social barriers to HIV risk reduction are prevalent in the Hispanic cultures through the concepts of “machismo” for men and “marianismo” for women. The men need to be dominant and experienced, however, the women are required to be dominated and inexperienced. Blacks have other cultural issues that add another concept “man-sharing” to the risk factors surrounding women and Black women have a double minority whammy (Campbell). Not enough eligible men are available due to many of the following social factors: and AIDS, heart disease or Sickle Cell anemia; homicide, jail or prison terms, as well as high rates of drug use and unemployment. Tolerance by Black women of their partners’ other women has developed a situation which may allow Black men to feel less allegiance to a monogamous relationship as their sexual options are seemingly unlimited. These women often fail to reduce the risky behaviors as the necessary life changes may involve real or perceived threats to their economic survival, their relationships as well as their culturally sanctioned roles. Again, this relationship of high-risk behaviors undermines the HIV and AIDS prevention programs available within the minority populace (Campbell).
Society needs to concentrate more on the individual than on the illness of the individual. To learn “that one has contracted a fatal illness creates immeasurable psychological distress and markedly changes how one approaches life. Relationships explicitly and implicitly transformed, many people withdraw and social support declines. Along with all of the direct effects of the disease on the person’s well-being, the person must deal with the stigmatization we have described” (Derlega 21). Additionally, fearing the inevitable rejection and stigmatization, the AIDS victim may withdraw from social activities and contribute to their own social isolation. The misguided focus of AIDS prevention on women “has made women primarily responsible for safer-sex practices, without attention to important gender power differentials. Controlling HIV disease will require acknowledging the fundamental differences in power relations between men and women. In particular, the growing number of AIDS cases among adolescents highlights the need to recognize and change gender power relations that promote the continued spread of the epidemic. This process requires that homophobia and sexism are confronted early in the socialization of heterosexual males” (Campbell 134). One problem in understanding the behavior of heterosexual men is the lack of research on heterosexual adults generally. In addition researchers have not studied the social context in which men interact with one another, and with women, as it relates to AIDS prevention (Campbell). One out of twenty-two sessions at the Eighth International Conference of AIDS in 1992 dealt with the need to change the attitudes and behaviors of heterosexual as well as bisexual men, however, no conclusions were reached and no information was disseminated regarding this very important attitudinal adjustment (National Institute of Mental Health).
In conclusion, there is no end to the misinformation in the American communities (and world wide) regarding the HIV and AIDS victims’ needs. The issues surrounding the education of care givers and support groups are overwhelming in the light of the prejudice evident everywhere due not only to the disease but the biases surrounding even the most innocent of the victims, the babies born infected and then categorized and branded for life by not only the effects of the disease but the stigma provided by the community. When asked in a recent survey (1995) how Americans felt about people with AIDS, the response was as follows: twenty-seven percent felt angry, twenty-eight percent felt disgusted, thirty-six percent mentioned being afraid, thirty-six percent felt AIDS victims should be separated from society and twenty-one percent felt they got what they deserved. Nearly fifty percent of the respondents said they would not shop in the store of someone who had AIDS and twenty percent indicated that they would avoid a co-worker with AIDS. Perhaps the most distressing statistic is that over ten percent said they would avoid a close friend who was infected. Overall more than seventy-five percent of the respondents stigmatized people with AIDS (Derlega).
In order to promote change to the stigmatization, it is essential that all avenues leading to the exposure of the myths and the misconceptions be eliminated through identification followed by education. The provision of education, including behavior modification and information of and to the general public, would enable the end of stigmatization therefore allowing society to become an asset to the victims instead of a liability. People with HIV and AIDS report “deep anger at others’ ignorance of their condition and that others’ dismissal of them” (Derlega 23) and “ironically, the stigmatization associated with AIDS may actually affect the health of the infected individuals in undesired ways” (Derlega 24). It is therefore imperative that the education, modification of behavior and distribution of information be directed not only to the non-infected public but also to the victims themselves.
Altman, Dennis.. Power and Community Organizational and Cultural Response to AIDS.
London: Taylor & Francis ltd, 1994.
Brown, Michael P.. Replacing Citizenship: AIDS Activism and Radical Democracy. New York:
The Guilford Press, 1997
Campbell, Carole A.. Women, Families, and HIV/AIDS: A Sociological Perspective on the
Epidemic in America. New York: Cambridge University Press, 1999.
Derlega, Valerian J., Anita P. Barbee., eds. HIV and Social Interaction. Thousand Oaks: Sage
Publications Inc, 1995.
Juhasz, Alexandra. AIDS TV: Identity, Community and Alternative Video. Durham: Duke
University Press, 1995.
Lupton, Deborah. Moral Threats and Dangerous Desires: AIDS in the News Media. London:
Taylor & Francis ltd, 1994.
Nationwide Survey Finds Continuing Stigma and Misinformation about AIDS. National
Institute of Mental Health. July 1, 1998.
Nelkin, Dorothy, Scott V. Parris, David P. Willis., eds. A Disease of Society: Cultural and
Institutional Response to AIDS. New York: Cambridge University Press, 1996.
Parker, Richard, Regina Maria Barbosa, Peter Aggleton., eds. Framing the Sexual Subject: The
Politics of Gender, Sexuality and Power. Berkeley: University of California Press, 2000.