Researchers cast doubt on hypothesis that stigma fuels HIV epidemic
The dominant view in the public health community is that the stigma of being HIV positive fuels the HIV epidemic, and yet there is a lack of evidence to support this view, say two researchers in a provocative essay in PLoS Medicine.
In a 2002 report, UNAIDS declared that the stigma associated with HIV was one of the "greatest barriers" to preventing new HIV infections and alleviating the impact of the disease. The standard argument for the link between HIV stigma and the global HIV epidemic, say Daniel Reidpath (Brunel University, UK) and Kit Yee Chan (Deakin University, Australia) is that stigma undermines HIV prevention efforts by making a person afraid to engage in safe behavior or seek testing for fear that these acts would themselves raise suspicion in the minds of others about the person's HIV status.
Reidpath and Chan say that there is no good evidence to support this argument. "To establish a causal link between HIV stigma and epidemic progression," they say, "requires longitudinal data on rates of infection and levels of HIV stigma. Weaker, but nonetheless potentially persuasive, evidence could also be found in an observed correlation between levels of HIV-related stigma and rates of HIV infection across contexts--such as between countries. Currently, no such evidence is available."
An alternative hypothesis, they say, is that stigma may in fact help to slow the epidemic. "It is plausible," they say, "that a social control mechanism, such as stigma, could reduce opportunities for contact between high- and low-risk groups."
"In writing this essay," say the authors, "our aim was neither to diminish the suffering of people living with AIDS in the eyes of the reader nor to advocate for the use of HIV stigma as a mechanism to control the spread of the epidemic. Our objective was to draw attention to the lack of evidence supporting the current dominant view on the relationship between stigma and the global spread of HIV."
Citation: Reidpath D, Chan KY (2006) HIV, sigma, and rates of infection: A rumor without evidence. PLoS Med 3(10): e435.
PLEASE ADD THE LINK TO THE PUBLISHED ARTICLE IN ONLINE VERSIONS OF YOUR REPORT: http://dx.doi.org/10.1371/journal.pmed.0030435
PRESS-ONLY PREVIEW OF THE ARTICLE: http://www.plos.org/press/plme-03-10-reidpath.pdf
Related image for press use:
- Caption: The Argument for the Link Between the Stigma of HIV and the Global HIV Epidemic
Centre for Public Health Research
Uxbridge, Middlesex UB8 3PH United Kingdom
+44 18 95 268 825
THE FOLLOWING RESEARCH ARTICLES WILL ALSO BE PUBLISHED ONLINE:
Time to renal disease and end-stage renal disease in PROFILE: a multiethnic lupus cohort
Fc? receptor genotype is a risk factor for progression of renal disease to ESRD but does not explain the ethnic disparities in renal disease progression.
Citation: Alarcón GS, McGwin G Jr, Petri M, Ramsey-Goldman R, Fessler BJ, et al. (2006) Time to renal disease and end-stage renal disease in profile: A multiethnic lupus cohort. PLoS Med 4(10): e396.
PLEASE ADD THE LINK TO THE PUBLISHED ARTICLE IN ONLINE VERSIONS OF YOUR REPORT: http://dx.doi.org/10.1371/journal.pmed.0030396
PRESS-ONLY PREVIEW OF THE ARTICLE: http://www.plos.org/press/plme-03-10-alarcon.pdf
The University of Alabama at Birmingham
510 20th Street South
Birmingham, Alabama 35294-3408 United States of America
+1 205-934-4602 (fax)
Immunodominance in primary HIV infection
A subset of CD8+ T cell epitopes within HIV-1 are consistently targeted early after infection. This could explain some of the protective effect of certain HLA class I alleles on HIV-1 disease progression.
Citation: Altfeld M, Kalife E, Qi Y, Streeck H, Lichterfeld M, et al. (2006) HLA alleles associated with delayed progression to AIDS contribute strongly to the initial CD8+ T cell response against HIV-1. PLoS Med 3(10): e403.
PLEASE ADD THE LINK TO THE PUBLISHED ARTICLE IN ONLINE VERSIONS OF YOUR REPORT: http://dx.doi.org/10.1371/journal.pmed.0030403
PRESS-ONLY PREVIEW OF THE ARTICLE: http://www.plos.org/press/plme-03-10-altfeld.pdf
Massachusetts General Hospital
Partners AIDS Research Center
149 13th Street
Boston, MA 02129 United States of America
+1 617-724-8586 (fax)
* * * * * * * * EMBARGO: MONDAY, 30 October, 5 P.M. PDT * * * * * * * * *
PLEASE MENTION THE OPEN-ACCESS JOURNAL PLoS MEDICINE (www.plosmedicine.org) AS THE SOURCE FOR THESE ARTICLES AND PROVIDE A LINK TO THE FREELY-AVAILABLE TEXT. THANK YOU.
All works published in PLoS Medicine are open access. Everything is immediately available without cost to anyone, anywhere--to read, download, redistribute, include in databases, and otherwise use--subject only to the condition that the original authorship is properly attributed. Copyright is retained by the authors. The Public Library of Science uses the Creative Commons Attribution License.
About PLoS Medicine
PLoS Medicine is an open access, freely available international medical journal. It publishes original research that enhances our understanding of human health and disease, together with commentary and analysis of important global health issues. For more information, visit http://www.plosmedicine.org
About the Public Library of Science
The Public Library of Science (PLoS) is a non-profit organization of scientists and physicians committed to making the world's scientific and medical literature a freely available public resource. For more information, visit http://www.plos.org
Last reviewed: By John M. Grohol, Psy.D. on 21 Feb 2009
Published on PsychCentral.com. All rights reserved.