World AIDS Day in the Days of COVID

Remembering and learning from World AIDS Day.

Posted Dec 01, 2020

 Mohamed Hassan/Pixabay
World AIDS Day
Source: Mohamed Hassan/Pixabay

Today marks the 32nd anniversary of World AIDS Day, the first global public health day. In today’s COVID-19 pandemic, it might be fitting to learn a few things from the AIDS pandemic, which has taken the lives of more than 35 million people worldwide.

One of the biggest causes of HIV/AIDS is exposure to bodily fluids—with the primary mechanism from sexual transmission. Today, approximately 38 million people worldwide are living with the human immunodeficiency virus (HIV), and many do not know they have it and may be spreading the virus to others. As the virus proliferates, targeting immune cells and weakening the immune system, it advances into acquired immunodeficiency syndrome (AIDS)—which can occur shortly after HIV infection, but many do not develop symptoms for 10-12 years after infection, while some are free of symptoms for a longer duration. According to amfAR, 54 percent of people living with HIV/AIDS are men who have sex with men, people who have injected drugs, sex workers, and transgender people; sexual partners, children, pregnant women, and women make up the other clustered demographics.

The sexual component of the disease's transmission, along with the heightened disease rates among men who sleep with men and IV drug users, led to stigma, mass fear, and abhorrent discrimination and hate crimes. When the disease was discovered in the early 1980s, it was an automatic and torturous death sentence. It was made worse by brutal stigma and shame with rampant rates of post-traumatic stress disorder (PTSD). While advances in medication and treatments have helped, the shame, loneliness, and isolation components still exist—along with fear to get tested and fear to share positive test results with a partner.

An interesting discovery that researchers made was that people with heightened anxiety, either as a result of discriminatory behaviors or internalized shame (most likely both), tended to engage in riskier behaviors (drinking, smoking, unprotected sex, drug use) and tended not to disclose the disease to their partner if they were positive.

For instance, Li, Li, Zhang, & Chow (2016) found that people living with HIV (PLWH) who had higher rates of stigma (external and/or internalized) were more likely to engage in sex with others without disclosing their HIV status. This was consistent among different areas like the U.S., South Africa, and Uganda—and was true for both males and females, and heterosexual partners who were afraid to disclose an affair-related infection to their spouse. However, men who sleep with men who were exposed to positive health training solutions more often used treatment-as-prevention (TasP), pre-exposure prophylaxis (PrEP), condoms—and were more likely to disclose their status to casual partners met through apps.

The powerful takeaway is that public health interventions that promote empowerment and solution-focused behaviors tended to enhance resiliency and the adoption of health-promoting and disease-prevention behaviors. Conversely, messages that perpetuated fear, stigma, and internalized anxiety tended to exacerbate the anxiety and consequent maladaptive riskier behaviors.

Of course, it’s a far more complex situation than can be easily summarized in a few sentences—and it took armies of people and decades to bring about hopeful changing tides toward health. Still, there are a few powerful lessons we can use in the continuing fight against HIV/AIDS and now COVID-19:

  • Getting anxious tends to make things worse—and can lead the best of us to put our heads in the sand, increasing the chances of succumbing to risky behaviors.
  • Information is lifesaving—listening to health experts and adopting safe and healthy behaviors can save your life and your loved ones'.
  • Isolation can make things worse—loosen the grip of shame and despair by allowing others to give you needed emotional support. There are more online support groups and resources than ever before.
  • Honor your truth by speaking up and suiting up—while the danger is real, the worse danger is people-pleasing yourself into a risky situation. Speak up. Use protection, get tested, and be consistent with other safe health practices (like masks and distancing for COVID).

For a little additional inspiration, we can bask in every line of “We Are the World.”

“…There's a choice we're making
We're saving our own lives
It's true we'll make a better day, just you and me…”

References

Li, H., Li, X., Zhang, L., & Chow, E. (2016). Effects of multiple types of stigma on the probability of HIV disclosure to sex partners: a systematic review. SEXUAL HEALTH, 13(6), 516–529. Retrieved from https://doi-org.ezp.waldenulibrary.org/10.1071/SH16089