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Stigma Prevents Many African-American Doctors From Testing for HIV

By Candace Y.A. Montague

August 3, 2011

Doctors shy away from testing because of stigma. Credit: MadameNoire.com.

Doctors shy away from testing because of stigma. Credit: MadameNoire.com.

A recent survey revealed that African-American doctors do not routinely test for HIV because of stigma. The study, commissioned by Janssen Pharmaceuticals, finds that although African-American doctors are concerned about HIV among their patients many of them only tested about one-third of them within the past year.

African-American physicians cited that social stigma keeps them from routinely testing their patients. The study results showed that doctors feel that testing every patient seems judgemental and offensive. Dr. Lisa Fitzpatrick, Infectious Disease physician at United Medical Center in Southeast and appointee to the Mayor's Commission on AIDS, says it's not just African-American doctors who are stumped by stigma. "I think physicians across the spectrum have pre-conceived ideas about who is HIV infected and who's not. I think providers still believe that they can decide who needs an HIV test and who doesn't. A lot of providers are still doing risk-based testing because they think HIV only happens in certain populations. We want all healthcare providers to routinely screen for HIV, especially in DC where we have such a high prevalence of HIV."

This survey also brings back up the debate about routine based testing versus risk based testing. Those who are against routine testing feel that it is costly and unnecessary to test everyone for HIV when they are not at high risk for infection. Should a 32 year-old married mother continue to get tested for HIV if she is only sexually active with her faithful husband? Questioning her sexual habits and planting seeds of doubt in her head about her husband's activities can be stressful and may cause friction within the doctor-patient relationship. Routine testing also assumes that a patient sees a doctor regularly or will have access to testing. For example, is it realistic to think that a chronically homeless man who is barely eating regular meals will put health care screenings at the top of his to-do list? Perhaps not.

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Doctors from the study offered solutions such as placing more patient-focused literature in their waiting rooms, more media attention on the importance of testing, and having a government mandate in place to force them to test more often. One way to reduce stigma is to keep HIV testing at the forefront of medical care for all doctors. Keeping HIV visible will help ease the shame and embarassment of having a test performed. Dr. Fitzpatrick says this is the best way to reduce stigma. "If this becomes a standard of care across the board then this will become as common as getting your cholesterol checked or blood pressure checked. I think this is the way to go because patients will start to see that this is a treatable, chronic disease and that no one is being singled out."

Dr. Fitzpatrick is also on the faculty at Howard University.

Feel free to share your thoughts here.


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See Also
What Does HIV/AIDS Stigma Look Like in Your Life?
More on Stigma and HIV/AIDS

Reader Comments:

Comment by: Abdul J. (Morristown, New Jersey) Mon., Sep. 12, 2011 at 7:53 am EDT
I would rather prefer routine testing over risk based testing because it is more comprehensive. It strongly suggests that less people at risk or otherwise affected slip through the cracks. An ounce of prevention is better than a pound of cure.
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Comment by: eljayhen (Cleveland, Ohio) Wed., Aug. 10, 2011 at 2:50 pm EDT
I didn't have risk factors for being HIV+, I thought I was in a "committed relationship". we were even engaged and yet here I sit HIV+. If they knew like I know, they would test everyone.
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Comment by: L0UIE (DC) Wed., Aug. 10, 2011 at 2:54 am EDT
WHEN I GO TO THE DCT TO GET TESTED THEYTEST ME FOR HIV OFF THEBREAK...WHEN I GO TO THE DCT FOR ANYTHING ELSE, THEY CONSTANTLY DISCUSS WITH ME THE RISK OF HIV/AIDS AND OTHER STDS. THEY MAKE SURE I AM FULLY AWARE OF WHAT IS OUT HERE AND HOW I SHOULD PROTECT MYSELF., CONSTANTLY PROVIDE FREE CONDOMS AND THINGS OF THAT SORT. IN THE DCTS OFFICE THEYHAVE BROCHURES ALL AROUND AND HEALTH MAGAZINES ABOUT HIV/AIDS ND STDS....ITS A DISEASE AND WE SHOULD NOT LEAVE IT UP TO THE DOCTORS AND MAKE IT SOLELY THEIR RESPONSIBILITY TO KEEP US AWARE OF OUR STATUS....AT WHAT POINT DO WE STAND UP AND TAKE RESPONSIBILITY???
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Comment by: Harvett (East Cleveland) Sun., Aug. 7, 2011 at 5:20 pm EDT

When will they learn? You don't have sex to catch anything, please test regardless.
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Comment by: Tony (Michigan) Thu., Aug. 4, 2011 at 2:06 pm EDT
I wish that they would have tested my husband at 32 even though he wasn't high risk.
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Candace Y.A. Montague

Candace Y.A. Montague

Candace Y.A. Montague has been learning about HIV since 1988 (and she has the certificates from the American Red Cross to prove it). Health is a high priority to Candace because she believes that nothing can come of your life if you're not healthy enough to enjoy it. One of her two master's degrees is in Community Health Promotion and Education. Candace was inspired to act against HIV after seeing a documentary in 2008 about African-American women and HIV. She knew that writing was the best way for her to make a difference and help inform others. Candace is a native Washingtonian and covers HIV news all around D.C. She has covered fundraisers, motorcycle rides, town hall meetings, house balls, Capitol Hill press conferences, election campaigns and protests for The DC Examiner.com and emPower News Magazine.

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