Monday, November 14, 2011

Social Change in the HIV/AIDS Epidemic- Managing Social Change

Over the last three decades, there have been many shifts in social change to the response to the HIV/AIDS epidemic. As the disease has transformed, so has prevention models used to educate those who are at risk as well as empower those living with HIV/AIDS. Awareness of the disease has been complex socially, culturally, politically, and most importantly, economically. The more stigmatized the disease is, the more vulnerable people are to becoming infected. Addressing prevention initiatives have shifted based on social change and stigma. In the beginning of the epidemic, prevention campaigns focused on providing education on transmission and risk behaviors. Once information is thought to be wide spread, the development of life sustaining drugs, and prevention campaigns focus more on the relationship of human rights and empowering individuals against intolerance and inequality.
In the beginning of the HIV/AIDS epidemic, there was a lack of information on the origin of HIV/AIDS and how it was transmitted. When the AIDS epidemic began in 1981, it was labeled a “gay disease” because the majority of documented U.S. HIV infections were from one specific demographic; gay white males.  The name GRID (gay- related immune deficiency) locked in stigma and discrimination towards those infected. After the onslaught of HIV in 1981, it soon became evident that AIDS was an international epidemic (or pandemic in some areas of the world) and most cases of AIDS have been diagnosed within the heterosexual community. The main reason for the stigma of HIV/AIDS is sexuality. In the United States, those initially infected were those whose sexual practices were considered out of the norm. There are still those who believe that homosexuals are the cause of the epidemic but as we now know, this is not true. Africa and other developing countries are examples that most HIV infections are among heterosexuals.
My first experience with HIV/AIDS was the diagnosis of a close friend in the small city I lived in. It wasn’t long before many of my friends were diagnosed with HIV/AIDS. There were no services available in the northwest portion of the state of Louisiana where I lived. More often than not, a positive HIV antibody test meant a death sentence within a year. Along with four other people, two of which had moved back to my city to die from AIDS, started a local chapter of ACT-UP (AIDS Coalition to Unleash Power) in 1986. We protested the lack of services that were provided those living with AIDS, as well as lobbied on the state level for funding to startup north Louisiana’s first HIV/AIDS resource center.
The early days of HIV/AIDS education was geared towards the simple mechanics of the disease and focus on disarming the stigma. Even though today it is still an issue, heterosexual women are the fastest growing number of new infection rates. “An understanding of stigmatization and discrimination as political and social processes can also help us to reconsider responses to HIV/AIDS-related stigma and discrimination”.  “For example, the social change involved in changing perceptions of the disease can be handed to marginal demographics of the group to resist the forces that discriminate the whole.
Groups such as women’s support groups and straight male support groups can be utilized to empower those who are HIV infected to disbar stereotypes. More and more women and straight men are coming forward speaking out about their own lives as HIV infected individuals. Unlike the early days of HIV/AIDS where HIV infected individuals hid their HIV status, now are coming forward as the “new” face of HIV /AIDS.
Another reason HIV stigma has changed over the years, is the development of new anti-viral medications. In the early days of the epidemic, there was one drug that was prescribed to everyone. AZT was a very toxic drug that seemed to reduce symptoms of HIV but later was thought to do more harm than good. HIV disease has become big business for pharmaceutical companies with patients paying over $1500 a month in medication. With such enormous expense came new anti-viral drugs that virtually eliminate the cell with HIV saturation. New HIV infection rates are lowered because the virus isn’t transmitted as often with lowered vital loads. HIV/AIDS medications are also a factor in lowering stigma associated with HIV/AIDS because it has become a controlled disease as long as the consumer takes their medication properly.
In summary, the initial response to HIV/AIDS was limited and stigma arose out of the lack of education. As society became aware of modes of transmission and the spread of HIV to other groups in society other than gay men, acceptance is slowly being seen. Perception and stigma change when empowering subgroups such as women and straight men to speak out for themselves. New anti-viral medication has changed life expectancy and attitudes about the disease. Those living with HIV/AIDS are living longer healthy lives and have become more accepted in society. HIV/AIDS is no longer a death sentence. 
References:

Ko, Marnie.  (2001, April). Rethinking AZT: HIV experts finally admit their deadly drugs sometimes do more harm than good. Report   Newsmagazine, 28(7), 50.  Retrieved November 13, 2011, from CBCA Complete. (Document ID: 770199811).
Parker, R. & Aggleton, P. HIV/AIDS-related Stigma and Discrimination: A Conceptual Framework and an Agenda for Action. Retrieved November 13, 2011, from http://pdf.usaid.gov/pdf_docs/Pnacq832.pdf

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