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Wilber Marmol

Dr. Giuliana Lund

ENG 1302

11/09/2024

Research Paper: Coping with Social Stigma


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Abstract Paragraph:

This research paper investigates the lingering social stigma of HIV and its effect on the

mental, physical, and social wellbeing of HIV patients. The paper discusses, through a critical

literature review, how HIV-related stigma, anchored on cultural prejudices, misinformation, and

historical fallacies, reinforces poor mental health manifestations such as anxiety and depression,

while discouraging people from seeking medical help. The stigma not only adds to poor access to

healthcare, leading to late diagnosis and treatment of health conditions, but it also contributes to

the social isolation of people, therefore harming their social network in that it takes away their

ability to maintain relationships and a sense of community. This further gets compounded around

healthcare, with patients remaining apprehensive about any judgment on the part of medical

professionals, thus missing out on essential treatments like ART. This study promotes education

for health care providers, public health campaigns, and media efforts to change societal attitudes

to more compassionate and knowledgeable views towards HIV. Such policies will improve not

only the quality of life for people living with HIV but also their health outcomes.
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Research Paper:

The widespread social stigma associated with HIV diagnosis can have a significant

negative influence on its carriers’ health in addition to the medical outcomes. HIV stigma

frequently results in serious mental health issues, with people dealing with higher rates of

anxiety and despair as due to social criticism. Furthermore, this stigma may deter people from

getting the care they need because many choose not to seek therapy at all out of fear of prejudice

or rejection from medical professionals. In the end, the social effects of receiving an HIV

diagnosis can cause people to become isolated from their support systems, which makes it

difficult for them to keep up relationships and a feeling of community. Because of this, people

with HIV frequently deal with additional challenges in their daily lives, which can impact their

physical and mental well-being as well as their capacity to sustain social relationships. These

factors highlight how difficult it is to deal with the stigma and discrimination that still exist,

especially in hospital environments.

Negative thoughts that society has about people living with HIV are referred to as HIV-

related stigma. This stigma is very widespread: “A study published in The Lancet HIV in 2019

found that 50% of people living with HIV reported experiencing stigma in their communities,

especially in lower-income countries where knowledge about HIV transmission is often limited

(Emlet,n.page).” This negative stigma is caused by several factors, including deeply ingrained

cultural biases, or even misleading information about the disease, and prior associations with

marginalized groups (such as guys who have sex with men, drug injectors, or sex workers). In

many countries, HIV is still viewed as a "moral" disease that is commonly linked to socially

unacceptable behaviors including drug use, promiscuity, and non-heteronormative sexual


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behavior. Because of this, individuals living with HIV can face prejudice and discrimination,

which can take many different forms, from overt verbal assault to more subtle forms of exclusion

and discrimination.

Historical settings, such as the first HIV outbreak in the 1980s, which was portrayed in

the media as a disease of gay people, which made the societal stigma associated with the virus

even worse. People with HIV were sometimes stigmatized as being at fault for their condition

because they were depicted as engaging in dangerous or immoral activities. Despite

advancements in medical care and knowledge, stigma still exists and continues to impact people

living with HIV in many facets of their lives.

People with HIV suffer from poor mental health due to stigma. Being shamed for having

the virus can result in long-term stress, anxiety, and despair, all of which can have an impact on a

person's physical well-being. People may form unfavorable opinions about themselves out of a

fear of being rejected or criticized by others, which can leave them feeling ashamed and

unworthy. People may be further isolated and experience worsening mental health issues because

of this internalized stigma, which can keep them from telling others they are HIV positive. This

is especially seen in younger carriers as described by Gary Harper: "Stigma associated with HIV

is closely linked to poor mental health outcomes. Adolescents and young adults who are

diagnosed with HIV often report feeling a sense of shame and self-doubt, leading to increased

anxiety and depression. These emotional struggles can significantly impact both their mental and

physical health" (510).

Studies have shown that people living with HIV are at a significantly higher risk of

experiencing depression and anxiety compared to the general population. The mental health
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challenges they face are often frustrating as they try to be in a society that judges them, and these

challenges can make the carriers struggle to face the disease. The stigma therefore becomes a key

factor in determining both the psychological and social lives of HIV carriers.

Social stigma takes the form of discrimination, which can occur in various places, such as

the workplace, and healthcare environments. Discrimination in healthcare environments is a big

concern, as it not only affects the carrier sense of dignity but can also impact the quality of care

they receive. As they may not be as open to healthcare or to even seek medical help (Anderson).

Refusing to seek medical care out of fear of prejudice is one of the most well-known

problems that persons with HIV confront. Because they fear being treated differently or even

refused care, many patients with HIV choose not to disclose their status to medical personnel.

Because untreated HIV patients are more prone to unintentionally spread the virus to others, this

reluctance to get treatment can result in delayed diagnosis, worse health outcomes, and higher

transmission rates. Bebe Anderson backs this up by saying: "When patients with HIV are afraid

to disclose their status, they risk not receiving timely treatment, which can exacerbate health

issues. Untreated HIV leads to worse health outcomes, including increased susceptibility to

opportunistic infections and complications. As a result, delayed diagnoses contribute to poor

quality of life and premature mortality" (n.pag.). This is extremely dangerous since any person

especially someone diagnosed with such a dangerous disease such as HIV should seek medical

help.

Healthcare providers are feared by the possible discrimination that can also discourage

individuals from looking to treatment regimens, which are crucial for managing HIV. (ART) is

critical for helping with minimizing the virus and maintaining a good quality of life, but people

diagnosed with HIV may struggle to stay on track with their treatment if they feel the social
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stigma effect by their healthcare providers or believe that their providers are not empathetic to

their needs. This is seen by what Carlisle Caroline: “Fear of discrimination from healthcare

providers can deter individuals from adhering to their treatment regimens. Stigma, whether

explicit or subtle, can create an environment where patients feel unsafe or unsupported, leading

them to avoid disclosing critical information or even to delay treatment" (112).

Additionally, the stigma associated with HIV may also prevent carriers from engaging in

preventive healthcare, such as routine screenings, mental health services, and support for other

co-occurring conditions. For carriers who live in smaller, rural communities, or in areas with less

access to healthcare, this stigma can be especially worse, making it difficult for them to find

healthcare providers who are both knowledgeable about HIV and discreet in treating people

living with the virus.

Additionally, social relationships—which are crucial for emotional and psychological

health—can be undermined by HIV-related stigma. Individuals with HIV frequently feel

ashamed and afraid of being rejected, which can cause them to isolate themselves from others.

This retreat may show itself as avoiding friends and family, stopping participation in community

events, or disengaging from support groups. Social isolation can exacerbate mental health issues

by heightening feelings of worry, despair, and loneliness.

Moreover, the stigma surrounding HIV can disrupt romantic and intimate relationships.

Which is specially more difficult with teens. As they take social stigma significantly worse than

other ages. Mark Liddell notes that: “A 2019 study published in The Journal of Adolescent

Health found that 40% of adolescents living with HIV experienced stigma in healthcare settings,

which can negatively influence their adherence to antiretroviral therapy (ART)” (4).
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The denial a therapy is a demonstration of how the disease affects them in an emotional level,

but that’s not the case for everyone. Many people living with HIV report difficulties in disclosing

their HIV status to partners, often fearing rejection or judgment. In some cases, partners may not

want to engage in sexual activity with their partners who has HIV, or they may feel betrayed

upon learning the status, leading to relationship breakdowns. This can result in a cycle of

isolation, where the carriers feel unsupported both emotionally and physically.

It has been demonstrated that HIV carriers have better health outcomes when they have

strong community support. By giving people the tools, they need to manage the difficulties of

living with HIV, social support can mitigate the harmful consequences of stigma. Support

systems, whether created by friends, family, or neighborhood associations, are essential for

lowering feelings of loneliness and improving a person's capacity to cope with their illness.

Reducing HIV stigma is essential for improving health outcomes and the general well-

being of people living with HIV, especially in healthcare environment or places. The experiences

of people with HIV are significantly shaped by healthcare professionals, and their perceptions of

the virus have the power to either increase or decrease stigma. It is possible to foster an

atmosphere where individuals living with HIV feel comfortable, respected, and understood by

educating healthcare professionals about their own prejudices and cultural competency.

Reducing stigma through public health programs is also crucial to altering public

perceptions of HIV. These efforts can include media representations that dispel myths about HIV

and people infected with the virus, educational activities, and awareness campaigns. Stigma can

be lessened over time by informing the public about the facts of HIV transmission and the

developments in treatment that have made HIV a treatable illness. Better mental and physical

health outcomes may result from increased acceptance and support for those living with HIV.
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Roger Pebody confirms this with some interesting statistics: “A 2018 study by the HIV and

Health Communication Agency showed that nearly 40% of people living with HIV experienced

stigma and discrimination, which directly impacted their willingness to seek care and disclose

their status.” (35)

The way that HIV is portrayed in the media can potentially positively affect public

opinion. public health initiatives that highlight public perceptions by providing truthful,

sympathetic, and humanizing portrayals of HIV-positive carriers. Which can be changed from

one of dread and humiliation to one of hope and understanding by highlighting medical

advancements in treatment, such as the ability of antiretroviral therapy to suppress HIV to

undetectable levels.

Furthermore, public health initiatives ought to focus on meeting the unique requirements

of underserved groups, including drug injectors, prostitutes, and LGBTQ+ individuals. These

groups are more susceptible to poor mental health outcomes and limited access to care because

they frequently experience exacerbated stigma and prejudice.

Ultimately the negative societal attitudes, towards HIV continue to pose a challenge for

those living with the virus by impacting their well-being and ability to access support and

maintain relationships, with others. Stigma, in healthcare environments appears in forms. Subtly

and, at other times more openly. Making it harder for people to access the necessary care they

require (Unaids).

In the end the well-being of individuals affected by HIV involves initiatives aimed at

diminishing the stigma associated with the virus— through training sessions and educational

campaigns, in healthcare facilities and workplaces. Addressing stigma can enhance individuals

access to healthcare services. Foster the growth of a community that treats those living with HIV
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with dignity and respect. There is optimism that as media initiatives and public health campaigns

work to debunk misconceptions about HIV and promote understanding of the virus realities. This

progress may lead to health outcomes and a society that is increasingly embracing and

supportive, towards individuals living with HIV.


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Anderson, Bebe. “HIV stigma and discrimination persist, even in health care”,

Journal of Ethics. Available at: https://journalofethics.ama-assn.org/article/hiv-stigma-

and-discrimination-persist-even-health-care/2009-12 (2009).

Caroline Carlisle, et al. “Stigma and Social Exclusion in Healthcare.”

EBSCOhost, research.ebsco.com/linkprocessor/plink?id=dfb63cd3-da13-3bfa-bca0-

fe6447e4def5. .” Routledge, 2005

Emlet, Charles A., et al. “The Impact of HIV-Related Stigma on Older and Younger

Adults Living with HIV Disease: Does Age Matter?” AIDS Care, vol. 27, no. 4, Apr.

2015, pp. 520–28. EBSCOhost,

https://doi-org.uhd.idm.oclc.org/10.1080/09540121.2014.978734.

Harper, Gary. “Stigma reduction in adolescents and young

adults newly diagnosed with HIV: Findings from the project accept intervention.” AIDS

patient care and STDs. Available at:

https://pmc.ncbi.nlm.nih.gov/articles/PMC4183905/#:~:text=The%20stigma

%20associated%20with%20HIV,well%20as%20decreased%20self%20esteem (2014)
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Mahajan, Alan., et al. "Stigma in the HIV/AIDS Epidemic: A Review of the Literature and

Recommendations for the Way Forward." The Lancet, vol. 372, no. 9636, 2008, pp. 939-

949. https://doi.org/10.1016/S0140-6736(08)61653-4.

Pebody, Roger. “What Is HIV Stigma?” Aidsmap.Com, 1 Feb. 2021,

www.aidsmap.com/about-hiv/what-hiv-stigma.

Unaids “HIV and stigma and discrimination.” Human Rights Sheet Series. Available at:

https://www.unaids.org/sites/default/files/media_asset/07-hiv-human-rights-factsheet-

stigma-discrmination_en.pdf (2021)

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