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In the 1980s,
school children who had contracted HIV through blood transfusions were
stigmatized almost as badly as homosexuals and often not even allowed to attend
public schools. It was only after the highly publicized case of Ryan White that
we saw the shift in attitudes and the formation of the innocent/deserving
distinction (Giblin, 1995). Social Implications The effects of stigma for PLWAs
are many. They suffer discrimination from the general public in a variety of
settings, including work, school and within the health care environment. In the
early years of AIDS, many PLWAs were actually refused service in North American
hospitals and some were fired from their jobs upon announcing that they had
AIDS. The fact that the Canadian Human Rights Commission felt it necessary to
specifically address HIV/AIDS discrimination is a good indicator as to what
point it exists. Many PLWAs also experience extreme social isolation due to
their illness; because of the negative reactions of friends and family members,
the seropositive person is often rejected by many members of their social
entourage.
(Giblin, 1995; Bishop, et al., 1991; CASW, 1990; l’Association des
Medecines de Langue Francaise du Canada, 1990 & Quam, 1990). The situation for
PLWAs has changed somewhat in recent years. Legislation has been passed in both
Canada and the United States making it illegal to discriminate against people
for having AIDS. A major turning point occurred in the U.S. in 1990 after the
highly publicised case of Ryan White. Ryan was a child with AIDS who was not
permitted to attend public school due to his condition. Shortly after his death,
a law was passed (the Ryan White Act) to try to prevent such discriminatory
actions from happening again. White’s story is not unique. At the same time that
he was being excluded from public schools, a family with two seropositive
children was forced to leave the Florida town they were living in after threats
of violence and an arson fire in their home (Giblin, 1995 & Quam, 1990).
At
approximately the same time as U.S. legislation was passed, the Canadian
government included AIDS under its human rights commission anti- discrimination
laws. Although some things have changed and laws have been passed, the effects
if stigma are still prevalent. Many people still express feelings of fear and
hostility towards PLWAs (O’Hare, et al., 1996). Most of the negative attitudes
felt and expressed are irrational but the effects can be devastating. One effect
is people’s tendency to avoid all contact with PLWAs which contributes to social
isolation. Also, even though legislation has been passed, discrimination still
does exist. When asked about the treatment he received at Montreal General
Hospital, an HIV positive patient explained that AIDS discrimination is far from
being eradicated and that PLWAs are treated in a very negative fashion in many
situations and environments (personal interview, 1997). Implications for Social
Work Social workers are and will be called upon to serve clients with AIDS in
almost all fields of practice. As the numbers of the HIV positive climb, PLWAs
will be appearing in nearly every area that social workers practice and even if
we do not desire or plan to work with this population we will be required to do
so and unable to ignore the issues of PLWAs.
There are many ways in which social
workers can address the issue of stigma, both in trying to alleviate its effects
and actually working towards removing stigma in our society. What is disturbing,
however, is that many social workers and social work students, when questioned,
say that they do not want to have to come into contact with PLWAs and may even
refuse to provide services to them (O’Hare, et al., 1996). Therefore a second
issue that must be addressed is the attitudes of social workers. Social Work
Practice One of the principal roles of the social worker is that of advocacy.
This is of particular importance in relation to AIDS related stigma. As
mentioned, PLWAs suffer from discrimination in a variety of settings. By
exercising their role of client advocate, social workers can help to ensure that
their clients receive the services they are entitled to and the proper,
non-discriminatory treatment when possible.
This includes advocating client
rights within the health care system, whether it be in hospitals or CLSCs,
within the legal system, and in community organizations. Along with advocacy,
social workers can push for further changes in legislation and policy to protect
the rights of PLWAs (CASW, 1990). Social workers can help to alleviate the
isolation experienced by PLWAs due to stigma through the establishing of support
groups. There are two forms of support groups that can be very useful in
countering feelings of isolation: groups for PLWAs and those for the PLWA along
with members of their social entourage. In creating support groups of PLWAs, a
social lieu can be created for those who otherwise have little social contact
and it can give a chance for members to exchange coping strategies. The drawback
of this type of group is that, although it facilitates social interaction, it
does not necessarily provide links to the non-seropositive population. Groups
that include the person’s social entourage, such as family and friends, can be
used to bridge gaps between the client and their social contacts that have been
damaged due to AIDS related stigma.
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