Twenty five years into the AIDS epidemic, how much have the public's attitudes toward the disease and toward HIV-positive patients changed?
That's the question that the MAC AIDS Fund, a philanthropic organization that supports HIV awareness and prevention programs around the world, was after. So the organization conducted the first global survey of people's perceptions of AIDS, polling people in nine different countries, including the U.S. The results were unexpected: Nearly half of the survey respondents thought that AIDS was not fatal. In India, where rates of HIV are rising, 59% of respondents believed that HIV is a curable disease. And 50% of people overall believed that most patients diagnosed with HIV are currently receiving treatment, when in fact only one in five of such patients received antiretroviral therapy last year.
The survey also suggests an enduring stigma surrounding HIV. Nearly half of the people surveyed reported being uncomfortable working with those who are HIV positive, while slightly more than half of the respondents did not want to live in the same home as someone infected with HIV.
It seems that a quarter century of AIDS education, public health campaigns and a continuous "mainstreaming" of HIV-positive people in the U.S. and Europe have done little to sort out the public's confusion. The problem may be that while advances in treatment and prevention have fueled a misguided sense of complacency about the disease, personal prejudices have kept the stigma and shame about HIV alive. "We may have overeducated the public about the effectiveness of treatment and the availability of treatment," says Nancy Mahon, executive director of the MAC AIDS Fund. "Understanding this is important to change the pace of the epidemic and the nature of the epidemic at this point."
Awareness programs have done a lot to promote acceptance of those affected by AIDS, but experts say we're still far from making the real changes in cultural attitudes and practices that can impact the epidemic. Foremost among such cultural roadblocks is the role of women, who, in many developing societies, are economically dependent on their spouses and don't often demand that they practice safe sex. Dr. Geeta Gupta, president of the International Center for Research on Women, notes that women bear the heaviest burden of AIDS around the world. "Women still have problems discussing safe sex with their partners," says Gupta. "This survey highlights the extent to which stigma continues to be a significant barrier to people being able to talk about the epidemic, to accept risk, and to access services. [It] highlights how much more we need to do in order to ... ensure that people around the world understand that HIV/AIDS is [still] an epidemic that puts them at risk." Even if it takes another 25 years or more.