Experts Say Stigma Tops List of Barriers to HIV Testing

This is the second story in a four piece series exploring HIV testing and AIDS in Michigan.

There are many barriers to people getting tested for HIV, but the human factors — stigma and fear — top the list, health experts say.

“There is still a lot of fear and prejudice and discrimination,” said Kaye McDuffie, early intervention coordinator for the Lansing Area AIDS Network.  “People have actually made an assessment of their community or family support system, and they have determined that no one would be there for them if they had HIV disease. So, without a diagnosis, they are able to maintain a fragile support system.”

The first installment of this series reviewed the September 2006 recommendations of the Centers for Disease Control and Prevention to expand HIV testing to all routine medical care for people ages 13-64. However, many medical facilities are not following the CDC guidelines, and state law may be part of the problem. This leaves the issue of HIV testing in the hands of the numerous HIV/AIDS service organizations around the state.

Besides the stigma that can be attached to an HIV diagnosis, McDuffie said other barriers to testing include where testing is provided, perceptions that the testing costs money, the times when testing is available, and people not perceiving themselves to be at risk for HIV infection.

Continued -McDuffie also cited what she called a “backlash” to effective treatment. “One of the drawbacks (of the new drugs) especially among young people is that they think it is no big deal (to test HIV positive),” she said.

A report card on state progress against AIDS,  released last week by the Michigan AIDS Fund,  also noted the lack of effective education about HIV transmission as one of the state’s failures.  “A lack of effective HIV prevention education contributes to our lack of progress in slowing the epidemic,” the report stated.

Jay Kaplan, staff attorney for the American Civil Liberties Union of Michigan’s LGBT (lesbian, gay, bisexual and transgender) Project and a contributor to the AIDS Fund report card, said a variety of reasons may keep doctors from testing for HIV.

  “They may not be comfortable talking about risk behaviors, or they may assume a patient is not at risk, without having that discussion,” Kaplan said. He said doctors reflect the same prejudices as  other members of society.

Kaplan and McDuffie both support keeping the informed-consent law as it is in the state of Michigan.

  “We know that there is something about this (testing HIV positive) that leads to discrimination,” Kaplan said.

For McDuffie, the issue is helping people stay HIV negative. “I feel if there is not time to do some sort of assessment to let the patient know what is putting them at risk, they can’t develop an effective strategy to eliminate risks,” she said.

Jihannh Jones, program coordinator for the Midwest AIDS Prevention Project, concurred  with McDuffie.

“If you are talking to someone about HIV and you want them to stay negative, you have to have that conversation with them,” Jones said.