On World AIDS Day, it is gratifying to see increased attention paid to stigma, which has a devastating impact on prevention, testing and treatment. Creative and thoughtful campaigns utilizing social media and other venues are beginning to make a difference. Some anti-stigma programs are even being mandated as part of international aid. While many programs don't yet effectively address institutional, governmental and religious power structures that perpetuate stigma, they are impacting education and skills to build empathy, each of which is extremely important.
I first heard the news that Malaysian Airlines flight 17 had been shot out of the sky at a stopover in Sydney, en route to the International AIDS Conference in Melbourne. I stared at the television in disbelief as the initial (and incorrect) coverage reported that as many as 100 conference delegates had been onboard. I felt numb even as the number of attendees on board dropped over the next few days to fifty and then, finally, to six, among them one of the world's leading HIV researchers from the Netherlands and an official of the World Health Organization.
I recently passed a major milestone: a big, round-numbered birthday that, frankly, I never expected to reach. It was odd to arrive at this point in my life because, having lived with HIV for over thirty years, I had good reason to suspect that I would not celebrate this passage, or for that matter, birthdays that occurred decades earlier.
As the old year rolls over, it's natural to review how well our lives have functioned during the past 12 months. Many of us take the opportunity to make resolutions about changing our behavior. These often concern diet, getting to the gym, or cutting back on other things that might not contribute to our health. This well-intentioned exercise often collapses, falling away within weeks (or even days) as our resolve and the routines of daily living once again intrude into our hope that this year will be different.
I have lived with HIV for so many years that the whole issue of disclosure seems moot. Every important person in my life knows my status, as do my colleagues, clients, and for that matter, anyone who comes across my postings on TheBody.com and The BodyPRO.com. I am well aware of the complexities of disclosure and work with others to address their concerns, but it has been a long time since I experienced the issue.
It began simply enough. My doctor's office called to say that he wanted to speak with me directly about follow-up lab results. When pressed, the staff said he would not discuss anything over the phone. We scheduled an office visit for the next available appointment, several days away. Over the years I have received the same summons many times. They begin with a call stating that the doctor needs to see me in person. Memories of those calls came flooding back, along with an uncomfortable heavy sensation in my stomach. Some of those calls have been devastating (cancer), others were non-events. I hung up the phone, closed my eyes and tried to center myself, with little success.
She arrived on the stage covered in colorful braids amid stylized African dancers. Drums played exotic rhythms as she unveiled herself before 800,000 people -- the largest in the history of Central Park. Dressed in a glittering orange suit with billowing fabric, Diana Ross welcomed the cheering masses as an ominous summer storm darkened the sky. She created a magic spell with song and, at one point, implored the audience to "make a wish and let it go." As dusk fell the winds picked up and sweeping veils of rain moved in over the park. Television cameras captured her soaked hair and face. Oblivious to the torrential downpour, she became one with the crowd.
It began rather insignificantly but quickly escalated. The group which I had facilitated for several years consisted of ten to twelve gay men of all ages, most of whom were HIV negative. That night I mentioned a new service for people living with HIV and one man asked, "Why do the positive guys get everything? What about us negative guys?" Another group member spoke up about poz friends who were eligible for all kinds of support. He was indignant that he had been laid off, was struggling and, unlike "them," lacked access to community services such as food banks and housing assistance. Someone else expressed annoyance, and a fourth growled his protest. A strong and divisive vein of anger within the gay community had been exposed.
Todd sat slumped on the sofa in my office. He avoided eye contact and described a particularly painful experience with stigma. He had recently come around the corner at his part-time job and heard several co-workers speaking about him and his HIV positive status. More specifically, they were discussing how he might have acquired the virus by speculating about the nature and frequency of his sexual activities. It was meant as a cheap laugh among themselves, but for Todd it meant much more. Although he made no effort to hide his HIV status and was "out" at the office about being gay, hearing his co-workers making disparaging remarks about his sex life and his health status in such explicit terms felt like a strong punch in his gut. He had a brief flash of anger, telling them to shut up, and then stormed out, pulling inward and automatically falling into the old habit of numbing himself by detaching from the emotional pain.
Oppressive temperatures were hitting the century mark, adding to the surreal scenery surrounding me. The air was thick with dust and it was unnervingly still, portending the violent storm that would sweep through in just hours. Before me, in the bright afternoon sun, was a sea of AIDS Memorial Quilt panels carefully assembled on the mall in Washington. They seemed to stretch forever. In the distance the dome of the Capitol rose above the colorful sea of fabric. Behind me, a volunteer somberly read the unending list of individuals claimed by HIV/AIDS.