The burning question

Published 03, Oct, 2013

David Philips on how we encourage the HIV-negative to stay negative without stigmatizing those living with HIV

The burning question

Less than five minutes after I made a Facebook post with a link to Postively Aware’s “A Day with HIV” awareness and anti-stigma campaign, a friend of almost 20 years messaged privately “I’m not HIV-positive. Why should I participate in this Day with HIV thing?”  For a rare few moments I was speechless.

I replied “I’m already living with HIV; so, why should I spend my time and energy on preventing new infections?!”  My friend quickly countered “Don’t be a dick!”

“And I rest my case!!”

In less than a minute, my friend and I acted out an unspoken tension among those concerned with HIV, one around which we carefully dance while proclaiming new campaigns for education and awareness, testing promotion, and combating stigma.  How do we, culturally and as individuals, reinforce a decided preference for the HIV-uninfected remaining that way, while avoiding negative connotations about those who are or will be living with the virus?

I would submit that developing the answers to this question is The Prime Directive for the next generation of HIV prevention and care.  New technology may do wonders in theory, but the human dynamic must change for new technologies to yield ideal results.

Now, think about that question for a bit, and think about how we would confront other diseases in the same light.  We would support a variety of behaviours that promote the maintenance of a healthy weight, and we would not dismiss the overweight or the obese as lazy, gluttonous, or unattractive.  

Are we really doing anything like this en masse when it comes to HIV?  I would argue not.

There are bright spots like A Day with HIV, but they get swallowed up by shaming and hyperbole that obfuscate the common goals...assuming that there *is* a shared imperative for keeping the uninfected uninfected and not discarding HIVers.  Condom Nazis...  Your mother was a barebacker...  Disclosure histrionics….  Filing the selection of non-HIVer sex partners under “stigma”...  Selling PrEP as the alternative for barrier-free intercourse when only PrEP+condoms vs. condoms-alone has been studied.  All of these things may give one an emotional charge, but they evade The Prime Directive.

No apologies for neither offering a cheerful narrative, nor delivering answers to a rhetorical question this time around.  It’s early in a new school semester for me -- epidemiologic study design and basic immunology (#nerdproud) -- and I invite you to put on your “thinking cap” with me.