Hours of Underpaid Grunt Work at the AIDS Clinic Really Did Pay Off.

"The Human Face of AIDS"
by Vivekananda Nemana
For Crossings Magazine, published on December 10, 2007. 

Working in an AIDS clinic in New York last summer introduced me to a world of issues that I normally wouldn't ever think of at home in Suburbia, America. It was my first personal exposure to the disease. I learned a lot about what it's like to live with HIV, about the medications, the bills, the insurance hassles, and the precautions patients have to take. I also learned that most AIDS patients on Anti-Retroviral drugs (ARVs) look and behave perfectly normal, and try to lead relatively normal lives. 

But soon after starting my post at the clinic, I went out to dinner with some new neighbors from the Midwest, and the topic of my employment came up. When I mentioned that I worked at an AIDS clinic, a look of horror-mingled-with-disgust crossed one girl's face, and she actually leaned away from me, as if I were an incarnation of the disease itself. I don't even have the condition; I only happen to work around people who do. Did she expect the virus to be covering my body and casually float into her mashed potatoes? 

It was then that I came to the realization that in New York we actually live in a bubble, a bubble of open-mindedness. In the largely left-wing city, especially in the NYU/Greenwich Village area, homosexuality is overwhelmingly tolerated and the issue of AIDS is pretty well understood; I've never met anyone living in New York who was taken aback by the fact that I worked in the AIDS clinic. So it's not hard to become deluded that everyone shares this mentality, that most everybody in the world realizes the difficulties that AIDS patients face and wants to help them overcome their struggle. That, unfortunately, is far from the case. 

In light of World AIDS Day, which took place on December 1, I'd like to take a look at where the AIDS issue stands today. There are currently an estimated 33.2 million people living with the disease worldwide, and roughly 3 million die each year due to AIDS-related causes, but we already hear a lot about the numbers and statistics. Here's another bone to gnaw on: for all those unfortunately diagnosed, what is life like? Not just their physical complications, but how do their respective societies see them? 

The reality is that the awareness initiatives such as those put forth on World AIDS day are designed to make us pity the victims of the HIV virus. That isn't necessarily a bad thing, but inside our bubble of open-mindedness, it's easy to assume that everybody else feels the same way. How could you not muster up an ounce of sympathy for the unfortunate casualty of an incurable illness? But massive misconceptions still exist about the way HIV is transmitted. AIDS is still shunned by mainstream society as a result of "perverted" behavior such as sex working. These stigmas result in unabated discrimination against HIV/AIDS patients. 

At the clinic, it was relatively common to hear about cases where patients are denied full insurance benefits or face issues with their employers because of their condition. A major reason for this is that in the United States, and elsewhere, many people do not realize that HIV is transmitted only through bodily fluids, and that the virus is killed when exposed to air. So the chances of contracting HIV from a co-worker are slim to none. Moreover, because a large proportion of AIDS patients are homosexual, people often couple their biases against AIDS patients with their prejudices against homosexuals. 

If such discrimination is happening in Greenwich Village, to some of the wealthiest people in one of the wealthiest parts of the world, then how much worse off is a poor HIV-inflicted person in an underdeveloped country, in a situation where survival is difficult to begin with? In these countries, stigmatization and misconceptions about HIV transmission are more severe. The introduction of the United Nation's report on HIV and AIDS-related discrimination in India begins by saying, "In India, as elsewhere, AIDS is perceived as a disease of the 'others' -of people living on the margins of society, whose lifestyles are considered 'perverted' and 'sinful'...People living with HIV and AIDS continue to be burdened by poor care and inadequate services, while those with the power to help do little to make the situation better." In China, according to a recently published article by Reuters, society's discrimination against HIV infected people "impede[s] the effectiveness of HIV and AIDS prevention efforts." 

What happens when such discrimination and ostracism exists is that people who test HIV-positive are marginalized as second-class citizens. Then the patients and their loved ones face the possibility of losing their jobs, social statuses and livelihoods, and in some cases are even victims of physical abuse. Ostracism is one of the worst punishments, because its victims are rendered unable to function as part of the society in which they live. They are marginalized to the extent that they lose their identity and sense of self-worth. In countries like the United States, organizations and awareness groups work to prevent this from fully occurring, but these movements are, after all, a luxury for the rich. 

Moreover, in many countries the stigmatization of the HIV-afflicted as "sinful" provides an excuse to not properly develop healthcare and resources for patients. By blaming certain groups for the disease, governments can thus excuse themselves from the obligation to care for the disease's victims. Even worse, people who are at risk for being HIV-positive are less likely to get tested from fear of ostracism and loss of well-being, and HIV-sufferers are "developing full-blown AIDS due to resistance to anti-retroviral drugs and a reluctance to speak out," according to the Reuters article. 

People have to know that AIDS is not spread by an individual or a specific group, but rather by society's reluctance to accept the problem as a crisis that needs to be solved. They have to know that brushing off HIV as a "disease of the sinful" only aggravates the problem, and that it needs to be de-stigmatized in order to make any progress. They have to know that overcoming prejudices and accepting HIV patients as a part of society is the best path to making AIDS a curable disease.