From the moment HIV was first identified, the virus has been surrounded with stigma and prejudice. Stigma can be used to marginalize, exclude and exercise power over individuals and groups within society who show certain characteristics. While the societal rejection of certain social groups (e.g. gay and bisexual men, injecting drug users, sex workers) may predate HIV/AIDS, the disease has, in many cases, reinforced this stigma.
Some countries have reinforced this stigma by placing the blame and responsibility for HIV/AIDS on those groups most affected, thus allowing governments to abdicate responsibility for responding to the HIV epidemic. There are still regimes around the world that will not recognise the scale of the HIV epidemic, or in some cases even the existence of the virus.
Across the world stigma, taboos and fear are a major drive of the continuing HIV epidemic. Tackling stigma and discrimination is critical to winning the fight against HIV. It is of vital importance that people with HIV are at the centre of the response to HIV.
Policy and practice can serve to reinforce stigma and stigmatisation. Within the UK recent case law has resulted in prosecutions of people with HIV who have infected their sexual partners. The Government have remained resolutely silent on the issue of criminalisation. The danger in such a legislative precedent is that those people who do not have HIV, or do not know that they have HIV will feel that the responsibility for safer sex lies entirely with the person who has HIV. This of course fails to recognise that almost one third of people with HIV do not know that they are infected. What is more, in stigmatising HIV-positive people, testing levels will be reduced, further increasing the prevalence of undiagnosed HIV.
Similarly, recent election rhetoric around compulsory testing will only serve to further stigmatise the virus, and reduce levels of testing and access to treatment. This runs contrary to the interests of public health, as people with undiagnosed, and therefore untreated, HIV are more likely to infect their partners. The USA still maintains border controls which mean that HIV-positive UK citizens are unlikely to be allowed access to the country, even for a holiday - this is despite a higher HIV rate in the USA than in the UK. Do we want to follow this example, or do we want to fight stigma and discrimination in the UK, and encourage other countries such as the USA to follow suite?