We've come a long way in our understanding of HIV and AIDS, but discrimination against people with HIV/AIDS is still rampant. Advances in research have made it possible to live with the disease, as people do with other chronic illnesses. But the greatest challenge for many people is still the stigma that accompanies the illness.

You may worry about what others will think about your diagnosis. Or you may fear coming out as gay or bisexual, or as an intravenous (IV) drug user. These worries and fears can encourage behaviors that put you and others at risk. These behaviors include:

• Avoiding getting tested for HIV

• Not using condoms

• Hiding an HIV-positive status from sex partners

• Avoiding medical care that can save or prolong your life

• Not taking medication as directed

• Hiding health problems from your family

The burden of AIDS is much higher among African-Americans. Homophobia and fear of people with HIV/AIDS are particularly strong in the African-American community. These fears mean that many people are afraid to acknowledge their sexual orientation or HIV-positive status. For these reasons, many prefer to risk infection rather than face the stigma of HIV/AIDS. 

The reality of discrimination

Experts warn that "addictphobia" has contributed to discrimination against those who were infected with HIV through IV drug use. "Addictphobia" refers to negative beliefs and misconceptions about people who use illegal drugs. Among these false notions are the ideas that addiction is a moral failing and that addicts are unable or unwilling to change. These prejudices have slowed the availability of treatment centers for people who abuse drugs. As a result, people who are HIV-positive, African-American, and use IV drugs often face three stigmas. This heavy burden can increase isolation, anxiety, distress, and depression among those who are HIV-positive.

Taking action to overcome discrimination

You have many ways to take action to reduce the stigma and discrimination you may be facing:

• Educate yourself and others. Discrimination against people with HIV is often rooted in a lack of understanding about the virus and how it spreads. Contact your local public health department to find community-based organizations that provide HIV/AIDS information, counseling, and testing.

• Know your rights. Federal law protects people with disabilities, including those with HIV infection, from discrimination. Laws such as the Americans with Disabilities Act (ADA) and the Fair Housing Act protect your rights in the workplace, in housing, and in other settings. For example, the ADA requires employers to accommodate the needs of workers with disabilities such as HIV/AIDS as long as they can still do the required tasks of their job.

• Become an advocate. One of the best ways to counter discrimination is to advocate for change in policies that prevent people with HIV from getting the care, housing, and respect they need.

• Consider being open with those you can trust. You can choose whom to tell about your HIV status. Not all of your friends and loved ones have to know. You need to think about who can give you the support and comfort you deserve. Although it may be stressful to talk about, being able to confide in people you trust and getting the support you deserve will be an enormous relief. It's also good to remember that you can't control other people's prejudices; prepare for possible negative reactions, at least at first.

• Seek support. Studies show that people with strong social support are less likely to feel stigmatized than those who are isolated. If you're uncomfortable seeking comfort from friends and family, contact your local public health department to find HIV support groups in your community. If you already have a close network, consider volunteering to give support to others with HIV.