While in was in Miami I did something quite unusual. I took the bus.
Most of my friends who live there had never taken one. Everybody gets around the vast city by car. The streets are full of cars that host only one person.The traffic is bad, the bus stops at every block. A journey that would usually take 25 minutes by car took me over 1 hour and half. Some of my friends warned me it could be dangerous. But most of the people on the bus were Hispanic pensioners. The only dangerous thing I could forecast was that one of those elders could slip and break a fragile bone. But luckly I was able to reach South Beach without anybody getting hurt.
On the bus there was an advert for HIV testing. It had the words ‘Negative’ and ‘Positive’ next to a ticking box. The caption said ‘One in 5 people with HIV doesn’t know they are infected: Stop The Spread, Get Tested.’ I found it quite puzzling that the advert didn’t focus on the fact that HIV is a treatable illness, and that people can have access to free medication. It seemed very odd that the advertisers thought it was sufficient to provide the altruistic motivation of “stopping the spread’, which essentially assumes that people would want to know that they have HIV, and take on the burden of living with this heavily stigmatized condition, purely in order to protect others. I don’t think it makes sense, especially in a country like the USA, so driven by individualistic values and motivations.
On the other hand there is quite a lot of evidence that good prevention and testing campaigns should go hand in hand with anti-stigma campaigns as well as providing information on access to free care and treatment. You can read more on this debate on this blog by Daniel Reeders.
On a personal level the depths of stigma have just slapped me on my face one more time. I have disclosed my HIV status, after a lot of difficulties to a person I was hoping of having a relationship with. Yes it is still very hard also for me. The response was hard. Part of the discussion we had was about testing, since this person (to my disbielief) had never taken a test. This is a fairly educated, and worldly person, with a basic understanding of how ARVs work.
When I asked why there was so much fear of taking The Test the reply was : “If I knew I had HIV I would kill myself”
When we mention HIV we mention so much more then the virus. The sense of tragedy those three letters bring is beyond all rationality. That is why anti-stigma campaigns as well as free access to medications and support need to be at the core of getting people tested.