A 2010 survey found that 66 per cent of the public agree that there is still a great deal of stigma around HIV. A similar number also believe more needs to be done to prevent discrimination. However, general awareness and knowledge levels among the public can still be startlingly low. People living with HIV regularly report being treated badly, receiving poor service or being discriminated against because of their HIV status. Significantly and disappointingly, this discrimination is most often encountered in public services and the NHS in particular.
A 2008 survey of people with HIV in London found that one third of people encountered discrimination because of their HIV status. Of those reporting discrimination, half said it had come from a healthcare worker: one in four from a dentist, one in five from a GP and one in ten from hospital staff.
We have supported people who have been bullied, intimidated and even threatened with violence because of their condition. Stigma and prejudice can compromise people’s personal relationships and fear of disclosure can prevent them from getting the kind of basic support that other people living with long term conditions can expect from family and friends.
The fear and isolation this creates can have a profound effect on a person’s physical and emotional health. In many instances, people living with HIV can require more support in dealing with the stress and anxiety caused by HIV stigma, than with the physical impact of the infection. Mental ill health and in particular depression is a common experience for people living with HIV and a 2012 study showed one in four had a current depressive disorder.
People living with HIV are often fearful of disclosing their status in employment or recruitment settings and many face barriers to securing or remaining in employment as a result. Similarly, many people are reluctant to disclose in settings such as with their GP or dentist, and this is turn compromises the level of support they can expect from public services.
From a public health perspective, HIV stigma also acts as a major barrier to HIV testing. It discourages people from coming forward for testing and can be a barrier to doctors recommending tests to people who may be at risk. This undoubtedly has an impact on late diagnoses in the UK which are currently at 50 per cent.
Legislation, such as the Equality Act (2010) is most welcome in this area and gives people living with HIV some means of redress. However, it does not solve the underlying problem and taking legal action after discrimination has occurred is an arduous and potentially costly exercise.