This chapter discusses prejudice and discrimination in terms of societal dimensions of HIV and AIDS, followed by a discussion of HIV prevention programs for injection drug users, HIV prevention for teens, and health care practices.
The chapter begins with an introduction that discusses the denial of the governments of some nations that AIDS/HIV was a problem for their people. This led to a failure to put in place public health policies to reduce the spread of AIDS, thus exacerbating the pandemic. The chapter extends the social impact of the AIDS epidemic to include not only people living with AIDS but also to everyone else that is impacted directly or indirectly by the epidemic
The concept of negative stereotypes as a cognitive basis for prejudice is introduced, and how this affected attitudes towards people with AIDS in the early days of the epidemic is described. The authors note that prejudice relates to attitudes while discrimination relates to actions. The role prejudice against homosexuals played in reaction of the general public to the AIDS epidemic in its early days and the change in attitude that occurred when groups with more positive stereotypes became infected is discussed. The role played by prejudice and discrimination in implementing HIV prevention programs for injection drug users is described. It is pointed out that even though a 1996 Kaiser Family Foundation poll showed that 66% of Americans supported needle-exchange programs, there are still some metropolitan areas in the USA, San Diego being the largest, where local politicians continue to oppose such programs.
The section on HIV prevention for teens recalls that American society, even before the advent of the AIDS epidemic, has always been ambivalent about discussions of sex with young people. On the one hand teenagers are exposed constantly to advertisements that implicitly endorse sexuality and drugs (in the form of alcohol and tobacco) when on the other hand they are exhorted to “just say no“ to sexual contact and drug use. It is pointed out that, as discussed in Chapter 9, a critical component for the development of a successful intervention program is the input from the target group themselves. The fact that teens are not usually involved in the planning of HIV prevention programs targeted at them, limiting their effectiveness, is discussed.
The chapter ends with a discussion of health-care practices and the more positive outcome in overcoming the discrimination that was initially experienced by AIDS patients in the health-care setting. The use of universal precautions and other measures have gone a long way to reducing the fear of AIDS by health professionals. It is pointed out that the AIDS epidemic has even contributed to the development of relatively new and positive health-care practices such as the use of hospices to care for the terminally ill.
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