Today, HIV/AIDS remains a global challenge. And for good reason: the 2030 targets aim to reach ‘zero’ new HIV infections, ‘zero’ AIDS-related deaths, and ‘zero’ stigma and discrimination against those living with HIV/AIDS (Rizki et al., 2020). Once a person has HIV, that person has a chronic disease affecting the immune system and leading progressively to a loss of the body’s natural immunity to disease and infection. AIDS is the terminal stage of HIV infection. Once it reaches the AIDS stage, even infections that would be considered minor in a healthy individual can become life-threatening. This decline in immune function leaves individuals highly vulnerable to ‘opportunistic infections’ such as tuberculosis (TB), candidiasis, and hepatitis—which frequently result in fatal complications (Rizki et al., 2020).
Today, HIV and AIDS have evolved into a widespread epidemic, affecting individuals across all demographics regardless of age, gender, occupation, ethnicity, or nationality. AIDS is frequently labeled as a disease resulting from ‘deviant behavior,’ as many factors triggering the infection are often found within high-risk groups, such as commercial sex workers, individuals with diverse sexual orientations, intravenous drug users, and those engaging in risky sexual practices (Paxton et al., 2005). Additionally, people who are concerned that they acquired an STI may isolate themselves out of fear of experiencing stigma and/or discrimination, or because they are living with HIV/AIDS. This disconnection prevents the generation of successful prevention, care and treatment solutions (Asrina et al., 2023). This highlights the depth of sociological and public health importance of the disease, as it affects people from all strata of society..
DISCUSSION
A large body of research took note of the social stigma that those with HIV experience. For instance, Mahamboro et al. discovered that members of these populations face stigma at multiple levels—at their healthcare facilities, in their local communities and even within their own families—which results in discriminatory attitudes and behaviours (Mahamboro et al., 2020). Fauk’s study confirmed these findings by stating that people affected with HIV/AIDS are stigmatized and discriminated against in family, community and health settings. Struggles such as labeling, personal item isolation, social avoidance, and medical care referral.. Perhaps the most disheartening thing was that some healthcare providers themselves admitted stigmatizing and discriminating these patients (Fauk et al., 2021). Many other studies cite the underlying reason for this prejudice: widespread fear of HIV transmission.
Manifestations of Stigma and Discrimination Against People with HIV/AIDS
The stigma and discrimination around HIV/AIDS stigma cover a wide variety of settings, e.g. home, work, friends and family, and the healthcare system. The testimony provided by one of the participants (Asrina et al., 2023) indicates that there is currently no clear way for people living with HIV to end their marginalization caused by the stigma and discrimination that surround HIV and AIDS:
“If someone is infected with HIV, it’s contagious, and it’s because they were involved in risky behaviors—that’s why they ended up with it.” (Male, 54 years old)
These views attribute the spread of HIV to a virus that easily transmits through ordinary social interaction. Such an attitude emerges from social behavior rooted in a basic misunderstanding of how the virus is genuinely transmitted. This now ubiquitous fallacy serves as justification for the rejection of people living with HIV/AIDS and thus sustains stigma and discrimination. Through this alternative reality, patients face immense social pressure and live with ongoing fear of their standing. This often compels them to resort to secrecy and deception about their illness, a reality echoed by a respondent in a study (Asrina et al., 2023):
“ I was diagnosed with HIV back in 2019; naturally, I was in shock… wondering what would happen if people found out. But I’ve been on treatment for three years now. If anyone asks what’s wrong with me, I just tell them I have TB and that’s why I have to take the meds. Eventually, my wife found out and she was devastated. Now, others know too—they avoid me, gossip about me, and refuse to even talk to me. No one wants to shake my hand anymore” (Male, 40 years old).
This testimony underscores that concealing one’s HIV status serves as a coping mechanism against a society that frequently denies them basic social acceptance. Furthermore, the public often perceives these individuals as violators of social norms who must be avoided. People living with HIV/AIDS suffer emotionally as a result of these stigmas and discrimination, and for some there is more pain resulting from the emotional impact of the stigma than the physical pain experienced by a person living with HIV/AIDS due to their disease.
The Impact of Stigma and Discrimination on Individuals with HIV/AIDS
The public’s narrow, largely incorrect view of HIV transmission risks future life quality for people infected with HIV. The burden of stigma and discrimination often results in people avoiding HIV testing – to serious consequences. People are likely to continue unsafe practices and risk further infections (that might have been preventable or treated easily had testing been done). Perhaps worse, people may neglect general care for themselves, driven by an expected decrease in their life expectancy. This very sentiment was captured in the testimony of a respondent in a recent study (Asrina et al., 2023):
“There’s no point in constantly taking medicine when our own families don’t even treat us like human beings anymore, and it feels like society doesn’t want anything to do with us… What’s the point of living like this?” (Initial Wu, 28 years old).
The compulsion of many living with HIV/AIDS to derive a meaningful social life is what drives them to the knife. The beginning of a lot of individuals develop into symptoms of mental-health disorders and so it inhibits their ability to continue caring for themselves and adhere to their treatment plan. This is particularly tragic, since you should be able to live a productive life comparable to someone who is not infected by following a physically and psychologically healthy lifestyle, by continuing to take part in therapy and by adhering to your treatment plan.
Strategies for Addressing Stigma and Discrimination
Irrational fear, misinformation, social disgrace and he/she not obeying religious and social rules all contribute to stigma and discrimination against HIV/AIDS people. The real issue. These misperceptions create an atmosphere of fear in which many people feel that social distancing and avoiding contact with the affected are the sole ‘safer’ methods for not getting infected. So, a social constructionist perspective has great power in deconstructing these barriers. This needs to be accompanied by accurate education and strong anti-stigma campaigns, while positive social support should be encouraged. It proposes the following initiatives to turn these ideas into action:
a. The Education Pillar, this program consists of a literacy campaign, curriculum integration, and ‘safe space’ certification. The literacy campaign will be implemented in the form of a science-based campaign stating that HIV/AIDS patients who undergo regular ARV treatment and have an undetectable viral load will not transmit the virus sexually. This campaign can be a powerful instrument to eliminate public fear. Then, through curriculum integration in schools, adding lessons regarding human rights, empathy, and the psychosocial impact of stigma and discrimination. This is expected to instill in children from an early age the priority of respecting others and understanding the harm caused as a result of not respecting others. Furthermore, through the ‘Safe Space’ certification, which will provide training for workers in public institutions such as offices, schools, and healthcare facilities. The objective of this training is expected to spark mutual respect and the creation of ‘Safe Spaces’ for HIV/AIDS patients.
b. Decostruction of Negative Stereotypes, This involves introducing anti-stigma ambassadors from among teenagers to speak actively about HIV through a perspective of humanity and compassion, aiming to eliminate the moral stigma that often serves as the foundation for discrimination. These youth ambassadors can also actively amplify anti-stigma campaigns on social media, an effort carried out to leverage the strengths of the younger generation in utilizing social media platforms.
c. Strengthening the Social Support Ecosystem, This initiative introduces peer-support assistance, the “HIV-Aware Family” program, and inclusive economic initiatives. Peer-support assistance for HIV/AIDS patients is carried out by providing emotional support that can strengthen patients and boost their morale to continue living their lives well. Next, the “HIV-Aware Family” program provides guidance for patients’ families to overcome internal family fears. This can create effective communication to support patient treatment adherence at home. Besides, it also sets up the “Inclusive Economic Initiative” to create more employment opportunities for those patients with HIV/AIDS. In this way, patients with HIV/AIDS can not only live as usual by social with their families and friends but also obtain financial security.
These interventions mentioned above should contribute to changing the public views which have long been formed by anxiety and misapprehensions. The mission is to bring about knowledge that does not only share facts but it is also to bring about thinking changes of how people views HIV risk and transmission, to attempt to dismantle stigmas about people living with HIV/AIDS through the mass media and create ‘safe’ space in which patients are accepted by society again.
CONCLUSION
Addressing HIV/AIDS is not just a battle fought in laboratories, but also one against public perception in the public sphere. Social construction through science-based education (the education pillar), the deconstruction of negative stereotypes, and the strengthening of the social support ecosystem are crucial foundations for eliminating the discrimination that has long been a primary factor hindering HIV countermeasures. This approach serves as a direct catalyst for achieving the Sustainable Development Goals (SDGs), specifically point:
o SDG 3 (Good Health and Well-being): Specifically, by ending the HIV/AIDS epidemic.
o And SDG 10 (Reduced Inequalities): By guaranteeing equal rights for HIV/AIDS patients to work, pursue education, and socialize without discrimination, which serves as the realization of a just society.
“Our success in ending AIDS is not measured by viral load figures alone, but through social construction that transforms HIV/AIDS patients from objects of discrimination into empowered subjects of development”.
Figure 1. Alignment with SDGs.
By: Nohan Noer Adnan
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