‘I’m Not One of Them’: Why People at Risk for HIV Don’t Get Tested

The stigma surrounding HIV has diminished drastically since it first appeared in mainstream nearly three decades ago. People no longer where face masks when they come in contact with an HIV positive client. And HIV positive people rarely suffer the public degradation and humiliation they did before. Education about the disease has contributed greatly to this shift. It has been well established that HIV/AIDs cannot be passed from one person to another through casual contact or by breathing the same air. However, sexual contact, blood transfusions, and intravenous drug use are ways the virus can be passed. Despite this knowledge, a large number of at risk individuals, specifically, men who have sex with other men and IV drug users, still do not get tested for HIV.

Valerie A. Earnshaw of the School of Public Health and the Center for Interdisciplinary Research on AIDS at Yale University wanted to find out why those most likely to contract the disease were the least likely to get tested for it. In a recent study, Earnshaw looked at discrimination, prejudice, and stereotypes as impediments to testing in a sample of 93 participants receiving methadone treatment. All of the participants were HIV negative, but were at high risk of contracting HIV. Earnshaw surveyed the participants and found that discrimination and prejudice related towards HIV did not contribute to testing resistance, but stigma did.

Specifically, Earnshaw discovered that the stereotype surrounding the HIV individual negatively impacted willingness to get tested. The more they endorsed the stereotype, the more they perceived their risk for HIV to be minimal. Therefore, they didn’t get tested as often as those who thought there risk for HIV was higher. In sum, the participants who endorsed the stereotype felt a strong disconnection from that image, believing that “they were not one of THEM.” This study underscores the importance of addressing the cognitive appraisals surrounding HIV, and not just the behaviors that put people at risk. “Differentiating between HIV stigma mechanisms in future work can provide critical insight into how to intervene in HIV stigma to increase HIV testing and improve HIV prevention among at-risk populations,” said Earnshaw.

Earnshaw, Valerie A., Laramie R. Smith, Stephanie R. Chaudoir, I-Ching Lee, and Michael M. Copenhaver. Stereotypes about people living with HIV: Implications for perceptions of HIV risk and testing frequency among at-risk populations. AIDS Education & Prevention 24.6 (2012): 574-81. Print.

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  • Carl

    January 8th, 2013 at 3:46 AM

    I have never understood that devil may care attitude that many people have with their health, and in this case with the health of others too. If you can’t do the time then you don’t need to do the crime so to speak- if you don’t want to even chance becoming infected with HIV then you do a better job at protecting yourself during sex. That’s the way it goes. I did see that they now have at home testing kits for HIV so maybe this will encourage more people who would have once been hesitant to at least try from their own home to see if they test positive. But to go around not knowing and continuing to engage in risky behavior with others, that to me is completely unacceptable.

  • Thomas

    January 8th, 2013 at 7:48 AM

    Wow! It’s been 3 decades ago? It seems like I was just reading about Ryan White.

  • S DeMaria

    January 8th, 2013 at 7:51 AM

    Maybe one reason these people don’t get tested is the same reason they have sex with men and use drugs-they are addicted to the thrill of risky behavior. If you like risk and living on the egde, responsible actions generally aren’t your thing. So, assuming being tested for HIV and taking your health is responsible, risk takers would want nothing to do with it.

  • D Patel

    January 8th, 2013 at 7:53 AM

    Not allowing yourself to see when you are at risk for something isn’t smart. People really need to know how to take care of themselves. especially if you are going to do drugs and sleep with a bunch of different people and stuff.

  • Madeline Alonso

    January 8th, 2013 at 8:34 AM

    Great post. Leaving behind the stigma and understanding as humans that is not only on other interest but ours to know whats going on with our health. Even with diseases and illnesses so hard to control and accept like HIV

  • Janna

    January 8th, 2013 at 11:14 AM

    One of the biggest problems that I think that some risky people have is that they want to get tested but then they think that everyone will know all about their past and judge them, and that mabe getting tested is too expensive for them.

    I still after all this time don’t think that a lot of people are aware of the many community services which are available to them to get them tested for free. And they are afriad of what other people will think about them.

    Either way, no matter what the reasons are, there has to be a way to stop the growth in numbers of those developing this disease that with just some money and more education could be so easily prevented.

  • emily

    January 8th, 2013 at 9:32 PM

    denial is not gonna save you people!unless u get tested u cannot be sure.but not being tested does NOT mean u r safe!I think the psychology behind this is “if I don’t get tested then I’m not affected” and that certainly needs to change.because not only are they minimizing their chances of recovery by delaying the diagnosis but r also putting others at risk by not getting tested.

  • stinger

    January 8th, 2013 at 11:22 PM

    not going in for a test proves that these individuals are aware of them being at risk.they just do not wish to acknowledge it.

    they need some help if you ask me.they may have other issues that pushes them into denial althought they are a high risk risk category.they are harming themselves and putting others at risk as well.

  • Cheryl

    January 9th, 2013 at 5:12 PM

    If you were labeled a pedophile, how would you feel when you went out in public or went to find a place to live. You would hate the stigma that people put on you and how you were perceived by the public. While you may suffer from mental illness, you would want to be treated fairly and with the same regard as anyone else.

    This is exactly how IV drug users and homosexuals feel. That they have been labeled and the stigma that exists for both can cause a great deal of shame and guilt.

    This shame and guilt is a part of what keeps them from testing for HIV and the fear of being stigmatized once again; now for being HIV positive.

    Many of the responses here are one of the reasons why these groups do not get tested. I work in Harm Reduction and have talked to many IV drug users and Homosexuals and the fear of what others will think and the negative attitudes they face is what keeps them from getting tested.

    Until you walk in someone’s shoes, don’t judge. How many of you have engaged in unprotected heterosexual sex and thought, “this person looks safe.” I am sure that there are many young people out there that feel this way. I realize we are not talking about this group, but it is the same thing really.
    How many of you have driven home after having a few drinks and thought you were fine to drive. You could of put yourself and others at risk.

    Your judgmental attitudes and the lack of resources and healthcare is a big factor in why these groups don’t get tested.

    And while heterosexuals is not being discussed, the number of men and women who don’t use condoms is quite high and they are just as responsible for the spread of HIV, if they have never been tested, or the spread of other STD’s. How many heterosexuals don’t know they have genital herpes, but yet will have unprotected sex and spread the disease.

    Before you judge others, take a look at yourself or your friends and family. Because I am sure you yourself or someone you know is engaging in risky behavior, but because it is two heterosexuals it is not looked upon as risky behavior when it should if you are not using protection.

  • PQR

    January 9th, 2013 at 10:43 PM

    Basic human nature of denial I would say.If I dont get tested then I dont have it.If it is not seen then it doesnt exist!

    This behavior alhthough harmful can give a sense of bliss in the short run and that is exactly what these people chase.Just like addicts!

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