October 31, 2011
Lisa Fitzpatrick, M.D., M.P.H., is a U.S. Centers for Disease Control and Prevention (CDC)-trained medical epidemiologist who has led HIV-related public health field investigations, including one among HIV-positive, young, black men. She is an appointed member of the Mayor's Commission on HIV/AIDS in Washington, D.C.
I was a new provider in the clinic, and she was one of my first patients, HIV positive for over 10 years.
As I entered the exam room and saw her staring out the window, I made at least half a dozen intuitive assessments about her. She was well-dressed; clearly a strong and authoritative woman; a well-respected professional with very high standards of herself and others. As she began to share her story, I realized I was correct on all counts. Judging by the questions she asked me, I was not spared from her high expectations.
And then it happened. In an attempt to answer a single, unwanted question from me, there was a pause, followed by a sea of tears that flowed first down the right cheek and then the left. When she was able to speak again, the answer was a quiet and shameful, "No." My question was, "Have you told anyone about your HIV status?"
They are crying because whether they have been infected with HIV for one year or 20, they are suffering with their burden in silence. They are crying because, as long as no one knows and no one asks, they can continue to deny the reality that this disease has become theirs. They are crying because they fear society will ostracize and shame them. They are crying because of stigma.
HIV has been with us for nearly 30 years. Still the myths are rampant, the misperceptions prevalent and the ignorance pervasive. People with HIV have a chronic and treatable disease -- a disease that can infect any sexually active person who is busy pointing a judgmental finger at someone who was unlucky enough to contract it. I am tired of watching my patients cry, because their tears are as unnecessary as they are preventable. They will continue to cry unless we frame HIV as the preventable and treatable medical condition it is.
We can stop these tears. We can stop them by acknowledging that HIV affects people from all races, creeds and socioeconomic classes. We can stop them if we approach HIV just as we do diabetes and hypertension. We can stop them if we respond to HIV-positive people without judgment or criticism.
I know we can conquer HIV stigma, because it is our own creation. But to be successful we must talk about HIV in our communities, in our churches, in our social circles and in our homes. Let's each do our part to free people with HIV from their secret burden, because I am tired of watching them cry.
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