HIV stigma: ‘We need to address the myths, misunderstandings and attitudes that continue to fuel it’

Stephen O’Hare

(Executive director of HIV Ireland)

Today, people living with HIV can live long and healthy lives. International research indicates that people who are on HIV medications to suppress the virus cannot pass on the virus. This health status has become known as U=U (undetectable = untransmittable).

However, despite the fact that HIV is now a chronic, manageable illness, people with HIV continue to experience stigma when accessing healthcare services. This can be because they come from a particular community more vulnerable to HIV, including the community of gay, bisexual and other men who have sex with men or because of how they acquired HIV, for example through injecting drugs. In other words, 40 years on from the first cases of Aids in Ireland, HIV is still seen as a moral issue, not a health one.

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The problem is that some of the staff in non-HIV specialist health services are some of the most likely individuals to make people feel stigmatised because of their HIV status. Discrimination in healthcare takes many forms, including outright refusal of treatment, taking unnecessary extra measures such as double gloving or keeping a person until the last appointment of the day. Such instances often arise in close contact situations between health care providers and patients such as dental care or eye care.

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HIV Ireland has found that 81 per cent of the discrimination-related complaints received by us relate to access to healthcare services. Some discrimination cases have been taken to the Workplace Relations Commission or the Labour Court.

The one small change that I would like to see in the Irish healthcare service is an end to HIV stigma. For this to happen, we need to address the myths, misunderstandings and attitudes that continue to fuel HIV stigma and discrimination in healthcare settings.

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One way that we as an organisation could contribute to ending HIV stigma in healthcare is to provide further education and training opportunities for healthcare staff explaining that HIV is a blood-borne virus and can’t be transmitted through coughing, sneezing, saliva or sweat. Furthermore, people who are on effective treatment can live long and healthy lives and cannot transmit the virus to partners. Indeed, under a grant from the Gilead Fellowship Medical programme we intend to produce guidance in partnership with the dental profession for use in training new dentists about HIV and ways to avoid stigma.