Stigma remains attached to HIV

Experts say social workers can help educate public

There are people who still aren’t quite sure how HIV/AIDS is transmitted, and are afraid of what it means, says NASW member Melissa Sellevaag, manager for Youth and Family Care Navigation at Whitman-Walker Health in Washington, D.C.

She says social workers can help prevent stigma, and spread education about the disease and how to prevent it. It’s important to know at least the basics about the virus, she adds, because whatever field of practice we choose, social workers will work with clients with HIV/AIDS.

“HIV doesn’t discriminate against anybody,” says Sellevaag, who helps HIV-positive clients and their families get treatment and support. “All social workers should know the basics: how you get it, what it is and how you prevent it.”

Karen Phillips, also an NASW member, says there is a lot of stigma associated with HIV, or human immunodeficiency virus. At its onset in the 1980s, the virus was first identified in the U.S. among gay men in New York and California. She says some may still thinks it’s a “gay person’s” disease, even though it’s not.

Phillips is the director of social work services at Health Services Center in Hobson City, Ala. The center receives funding from Ryan White, a federally funded program that allocates money to health resource services across the U.S. Ryan White funding is designated to help those with HIV.

“The stigma is still so huge, and there are a lot of old-school mind-sets that carry a really strong judgment towards someone with HIV,” Phillips says. “There is a stigma that HIV goes hand in hand with being gay, or a drug user, or a prostitute. But that’s not always so. I’ve seen married couples infected (one or both of them), and everyone who has a child has had unprotected sex.”

NASW member Lisa Cox is associate professor and social work program coordinator at The Richard Stockton University of New Jersey. She says the practice of social work regarding HIV/AIDS is essential, and there is a need for more social workers that have expertise in this area.

“In the 1980s and early 1990s, some universities and departments of social work would offer courses in HIV, which seems to have gone by the wayside now,” Cox says. “But you never know when you’re going to run into someone with a diagnosis of HIV. Social workers need to seek out HIV training, and be aware of the ethical, co-occurring mental health and substance-abuse issues that can accompany someone infected.”

Phillips says the training social workers receive helps them understand not only the person who receives an HIV diagnosis, but also how the diagnosis affects that person’s life.

“Social workers are very nonjudgmental about things,” she says. “When we’re dealing with people, we’re (hopefully) not making a judgment on their behavior or basing our work on how they contracted (HIV).”

Social worker Paula D. Foster has been working with clients with HIV/AIDS since the early 1990s, and says that an HIV diagnosis isn’t the death sentence it once was. People are beginning to understand that it’s treatable, she says, but adds that there may be a fear of touching someone who has HIV/AIDS and a misplaced fear of contracting it.

“You can’t get it from shaking someone’s hand. I’ve done a lot of HIV-related trainings over the years, and there are some who feel HIV is transmitted much more easily that it is,” says Foster, who also serves on NASW’s national board. “Like the good social workers we should be, we should acknowledge fears, but also have a better understanding of the thing making us fearful.”

For social workers interested in working with HIV clients, Cox says ongoing education is important and the NASW HIV/AIDS Spectrum Project is a good place to start.

“It offers a specialized kind of set of resources that a social worker needs to become more knowledgeable about HIV,” she says.

Phillips says that someone interested in pursuing work in this area should study, read and learn about the course of the disease, risk factors and prevention. It is a public health issue, she says, and social workers can help with prevention and awareness measures.

“The very things that concern them will be questions that they get as they work in this area,” she says. “People will ask ‘Am I at risk?’, answers will be ‘Are you drawing their blood or having unprotected sex?’”

Getting into the HIV field may vary from community to community, and Sellevaag recommends that social workers develop a basic understanding of the disease and ask all the questions they can.

“Look to medical providers for employment opportunities, get as many trainings as you can, and learn about the life cycle, medications, and how HIV works, Sellevaag says. “Once you have that down, you can apply that knowledge anywhere.”

The NASW HIV/AIDS Spectrum Project provides HIV and mental health practice skills for people working in social work, mental health and substance abuse fields to enhance and promote culturally competent practice with individuals, families and communities affected by HIV/AIDS.

More information:

The Ryan White Care Act

Ryan White was one of the first children to contract HIV through a blood transfusion. He was diagnosed in 1984.

"He encountered a tremendous amount of discrimination and poor treatment after being diagnosed," says Karen Phillips, director of social work services at Health Services Center in Hobson City, Ala.

White's mother became an advocate for research and funding for HIV-related care. The Ryan White HIV/AIDS Program (the Ryan White Care Act) is the largest federally funded program with dedicated funds to provide HIV care and treatment.

Phillips says a large portion of the funds goes to direct medical care for people with HIV, which includes medical case management, medication and allied support services often provided by social workers (for example, mental health services).

There is no longer a risk of contracting HIV through blood transfusions because of advances in blood testing and screening for donors to ensure blood supplies are safe, Phillips says.