HIV and the Damaging Effects of Exclusion – Jenna

As soon as we found ourselves in a near-worldwide lockdown when COVID hit, I don’t think there was any doubt in most people’s minds that the virus was a crisis. Because of its ability to affect anyone, especially the elderly, society responded to it on a massive scale. Even the conspiracy theorists saw it as a crisis, though one of freedom rather than epidemiology.

The HIV crisis of the 1980’s moved through a very different series of events in its efforts to be recognised as the destructive disease that it is. The struggle for acknowledgement ultimately seemed to come down to two primary factors, the first being general homophobia (4). The general public’s designation of gay people (especially men) as deviants, meant that a disease that was more common in gay men at the time wasn’t exactly the most effective in garnering sympathy from the wider population (3). While that stigma still exists today, it is greatly diminished, especially in Western nations with more liberal ideologies. Additionally, ongoing education campaigns about the transmission of HIV and its corresponding harm reduction strategies have been incredibly successful over the years, and HIV/AIDS education is now included in most science-based sex education for adolescents (2).

The other factor is the minority status of the group that was considered to be most affected. Being openly “out” was less common than it is today, understandable given the increased risk of falling victim to hate crimes, professional discrimination, and public shame (3). The smaller population of activists may have been working to demonstrate the risks of HIV to everyone, including non-sex-related transmission, but the strength in numbers was lacking. In many people’s minds, it was a problem that did not affect them to a significant degree, and as a result, the HIV-positive community was, in many ways, excluded from the same level of urgency afforded problems that affect a larger population. 

I’m writing this blog post several weeks late, but I feel like it ties into an aspect of the most recent week’s topic: how do we approach public health when there are limited resources? The withholding of life-saving drugs and results by pharmaceutical companies that we see in 120 BPM seems not to be a problem of resources, but rather of corporate greed, but what about in cases where resources are scarce and the affected party does not hold much sway, socially and/or size-wise (1)? It seems like that would vary from a state to state basis and how they interpret their personal commitments to the health of their population. This is an ongoing debate, about whether it should be approached from an individual point of view, or by looking primarily at the benefits to the wider problem. However, regardless of institutional organisation, under no circumstance should access to care be based on whether the individual is part of an accepted group or not, because then it ceases to be a concern of allocation, or obligation, and instead becomes a direct attack on individual freedom and equality.

References

  1. Campillo R. 120 BPM. France: Memento Films; 2021.
  2. History of HIV and AIDS overview [Internet]. Avert. 2021 [cited 12 March 2021]. Available from: https://www.avert.org/professionals/history-hiv-aids/overview
  3. Anthony A. ‘We were so scared’: Four people who faced the horror of Aids in the 80s [Internet]. the Guardian. 2021 [cited 12 March 2021]. Available from: https://www.theguardian.com/society/2021/jan/31/we-were-so-scared-four-people-who-faced-the-horror-of-aids-in-the-80s
  4. Morris B. History of Lesbian, Gay, Bisexual and Transgender Social Movements [Internet]. https://www.apa.org. 2021 [cited 12 March 2021]. Available from: https://www.apa.org/pi/lgbt/resources/history

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