Persistence of stigma toward people living with HIV has puzzled scientists looking at the numerous destigmatization campaigns that have taken place in the U.S. in the four decades since its initial discovery. Scientists have explained the presence of stigma with the fact that people with HIV have in the past been legally excluded and marked as criminals, and because of the overlap in LGBTQ+ populations and HIV-positive people.
A first-of-its-kind research paper from Northwestern University presents another potential cause behind persistent stigma: an association of the chronic condition with a person's morality.
"We talked about this idea that the stigma will be persistent when there is an ethical component to it," said lead author Shahin Davoudpour. "It makes sense theoretically; when people think something is your fault, they're more likely to continue to blame you for it and think they need to distance themselves from you."
Davoudpour measures public health outcomes for the medical social sciences department at Northwestern University Feinberg School of Medicine.
The paper, published today (Feb. 21) in the journal Public Health Ethics, uses data from the 2021 and 2022 waves of the General Social Survey (GSS) - a biannual National Science Foundation-funded survey assessing demographics and attitudes - as a vehicle to evaluate the relationship between comfort with proximity to people with HIV and moral beliefs associated with HIV status.
The results confirmed the team's hypothesis: stigma seems to be more likely when immorality is associated with the stigmatized status. Individuals who "strongly agree" that people with HIV engage in immoral activities were over 13 times more likely to reject proximity to them compared to respondents who "strongly disagree."
Even factors like beliefs about same-sex sexual activity and awareness of discrimination against people with HIV did not seem to explain the findings when they were considered during analysis.
As Davoudpour and his team sifted through data and research to support the novel findings, he noticed there was very little quantitative data on the topic of morality as it pertains to stigma.
The National Opinion Research Center's study allowed Davoudpour to create a table and use complex data analysis techniques to begin to fill in the research gap.
Working from another scientist's data can be limiting because questions may not be precise enough to develop specific conclusions, and Davoudpour hopes to conduct a study of his own with more refined behavioral ethics measures attached to HIV with which to compare his team's discovery.
In the meantime, Davoudpour hopes that implementation scientists and advocates working to end HIV use the research to inform strategies to destigmatize HIV.
"Specifically, we encourage scientists and policymakers to consider the role of moral perceptions when redesigning their messaging campaigns, emphasizing the dissociation of HIV from morality," the researchers write in the study. "Additionally, researchers should consider exploring how perceptions of individual agency and morality influence these stigma reduction efforts, which could further enhance the effectiveness of interventions aimed at reducing HIV stigma."
