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Microaggression and Bias in the HIV Community -- and What We Can Do About It

August 29, 2016

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Olivia G. Ford

Olivia G. Ford (Credit: Selfie by Olivia G. Ford)

"Her 'ghetto' is showing."

"You act white."

"He's really handsome for a trans* guy."

"You're a single mom? But your daughter is so well behaved."

"I don't see color."

"You don't look like you have HIV at all!"

"Oh, did I offend you? You should have a thicker skin."

Have you ever had that experience where someone says something that was meant to be neutral, or funny or even complimentary, but it felt like a dig at your (or someone else's) race, gender, HIV status, sexuality or some other part of who they are?

If so, then you have experienced a microaggression. Microaggressions, according to psychologist Kevin Nadal, Ph.D. and others, are

brief and commonplace daily verbal, behavioral, or environmental indignities, whether intentional or unintentional, that communicate hostile, derogatory, or negative slights and insults toward members of oppressed groups.

They're called "micro" because they often happen between people or in intimate groups. But there is nothing small about them. We have seen how LGBT bullying can drive young people to suicide; perceptions of black people being inherently dangerous can lead them to be murdered just for walking or driving down the street; and persistent stigma allows the HIV epidemic to flourish.

The term "microaggression" was originally coined in academia in the 1970s by trailblazing psychiatrist Chester Pierce, M.D., to specifically describe race-based insults and slights leveled at black people by non-black people. The idea has found its way into mainstream conversations in recent years. Recent work has shown how microaggressions are aimed at members of many other oppressed or targeted groups: LGBTQ folks, women, people with disabilities, immigrants and many more, including those whose identities are at the intersection of several forms of oppression. HIV status can also be a target of microaggressions. I asked several community members to share a few of their "favorites," sampled below.


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Unpacking Microaggressions

Microaggressions generally fall into three categories.

Microassault: A conscious, intentional discriminatory action, such as calling someone a derogatory term or avoiding them because of some aspect of who they are.

  • "I have overheard friends say while checking their 'dating apps': 'He's so hot, but he's positive,'" says David Duran. "Of course it's always said in a disappointed tone. I've had friends realize I was sitting next to them, openly HIV positive, and still say it."
  • "When heterosexual men, often almost forcibly, follow up the announcement of their HIV status with 'and I'm not gay,'" Kari Hartel commented, "or when someone indicates that they are living with HIV, but not 'fill-in-the-blank' (typically 'a drug user/junkie/crackhead, a slut/prostitute/hooker', etc.). This implies that having sex, using drugs or being gay is something 'bad' and they're 'better than that.'"

A person who delivers a microassault may recognize they have a measure of bias against a group of people, but may feel justified in it and express it publicly.

Microinsult: A comment or nonverbal communication that conveys rudeness or insensitivity toward some aspect of a person's identity.

  • "When people ask what I do and I tell them that I work at an HIV clinic and then they follow it up with one of the following: 'Oh, that must be so sad.' 'Oh, that must be so scary.' 'Oh, you must be so brave.' 'Oh, that must be so hard,'" Kari said.
  • "Being told that not only do I not 'look gay,' but they would have never thought I was HIV positive," said Tony Christon-Walker, an HIV advocate in Alabama. "It's almost as if they think they have a HIV-dar, very similar to gaydar, which also doesn't work."

The sneaky thing about microinsults is that sometimes they're disguised as compliments. The person saying it may truly believe they are making the person on the receiving end feel good.

Microinvalidation: A communication that subtly excludes, ignores or dismisses the feelings, experiences or realities of members of oppressed communities.

  • "A friend told me he had just gotten tested. When I asked him the result, he answered, 'Oh, it's all good. I'm clean,'" said Rick Guasco, creative director at Positively Aware in Chicago. "I told my friend, 'If you're clean, what does that make me?'"
  • "A person who knows about my status once asked me about an HIV-negative man that I was dating: 'Do you two have sex?'" Asha Molock remembered. "I responded: 'Seriously? No, we just rub noses. We practice safe sex; don't you?'"
  • "I feel there's a lot of anger from the black community that's not productive. HIV is not just a black disease." This sentiment, highlighted on a recent community webinar, may have been an attempted gesture at solidarity across HIV-affected communities. However, the comment both erases black people's experiences and downplays the fact that the HIV epidemic is raging in black communities as in no other, both in the U.S. and across the planet. Solidarity requires listening, not microinvalidation.

Microaggressions are often unconscious, and people delivering them most likely have little idea of the impact they make. But research shows they can be even more harmful because of their invisibility.

Perhaps you've also had the experience where, just as quickly as a comment socked you in the gut, you explained away your reaction, telling yourself the person "didn't mean anything by it" and maybe you are just "being oversensitive." You may fear a defensive response if you approach the speaker, and if you don't approach them the episode may weigh on your mind, sapping an enormous amount of energy. You're damned if you do and if you don't.

Research also indicates that experiencing microaggressions can impact a person's work, education, physical health, emotional wellbeing and much more. And microaggressions impact those who express them, as well.

Microaggressions are often gateways to a teachable moment, but framing them as microaggressions acknowledges the harm done to the person on the receiving end. That is just as important to address as the microaggressors' learning processes.

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