News-Letter

Shame, blame and fear of social isolation have caused many individuals in communities around the world to ignore HIV/AIDS until it is too late. This stigma has prevented the successful treatment of HIV in many developing countries.

New research from the Bloomberg School of Public Health may help medical practitioners understand this powerful but ultimately counterproductive phenomenon.

The Hopkins tream has been measuring the patterns and importance of social stigmas in Thailand and Zimbabwe, two developing countries with very different HIV/AIDS rates, in hopes that this information will allow more effective treatment in these countries.

The study involved a public survey consisting of 22 questions that ask subjects to rate the extent to which they agree with a variety of statements about the disease.

Some of the statements included: "people living with HIV/AIDS should be ashamed," "people who have HIV/AIDS are cursed" and "people with HIV/AIDS shoud not have the same freedoms as other people."

There were three main themes tested in the survey: shame, perceived discrimination and equity for people living with HIV/AIDS.

The study found much greater stigma against HIV/AIDS patients in Thailand than in Zimbabwe, perhaps because the disease is not nearly as common in Thailand.

Zimbabwe has the fourth highest rate of HIV infection in the world, with approximately one-fourth of all adults infected. Only about 1.5 percent of Thai adults are infected; the country is ranked 17th worldwide.

Interestingly, the group found that in Zimbabwe, where infection rates are considerably higher, there is correspondingly less social isolation and discrimination associated with HIV-positive status.

One major factor in this widely shared attitude may be due to the fact that many respondents to the survey in Zimbabwe are likely to be personally acquainted with someone with HIV/AIDS, while for many respondents in Thailand the questions are more abstract. Psychologists have often described this effect in a variety of social situations.

The researchers also found that this cultural attitude may have actually led to increased effectiveness of HIV treatments in Zimbabwe, a promising finding for future public health projects.

The findings imply that when people have more accepting attitudes toward HIV/AIDS, they are more likely themselves to get tested and seek treatment, as well as to be supportive of friends and family with the illness.

Further characterization of the social stigmas surrounding illnesses such as HIV/AIDS may eventually help physicians and public health experts to improve the effectiveness of treatment in a culturally-sensitive manner.

The paper appears in the December 2007 issue of the journal AIDS Behavior. The research was led by David Celentano at Hopkins and collaborators in Thailand and Zimbabwe.

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