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Public attitudes towards HIV

Attitudes towards and understanding of HIV are continually changing. Throughout its history HIV has triggered a range of social and emotional responses from fear, denial, stigma and discrimination to compassion, solidarity and support. Experience has shown us that understanding and knowledge play a large part in determining a person’s response to HIV. But where are we today? How much do people know? Have we moved beyond the stigma? What more needs to be done? The National AIDS Trust has been investigating.

t the National AIDS Trust we believe that we can make a lasting and positive impact on the greatest number of lives by working to influence and inform attitudes, behaviour and decisions of governments, organisations and individuals. In order to achieve this we must first understand the attitudes that inform people’s behaviour and decisions. That is why we commissioned the Public Attitudes Towards HIV 2007 survey. The survey, conducted by Ipsos MORI, is the third of its kind since 2000. Using a representative sample of the British population, it aims to determine people’s attitudes to and understanding of HIV. The results were released in February 2008.

Over seventy per cent recognise that people with HIV can work like anyone else,
compared to sixty-six per cent in 2005.”

The Public Attitudes Towards HIV 2007 survey revealed a serious gap in knowledge about HIV. Ninety per cent of the UK population are unable to identify all of the main routes of transmission without any of the false routes. And worryingly, knowledge appears to be declining. The survey revealed fewer people in 2007 are able to identify each of the correct ways in which HIV is transmitted than did so in 2000. Over a fifth (21 per cent) did not identify unprotected sex between a man and a woman as a way of contracting HIV. In 2000 just nine per cent did not identify this route. In 2007 over a quarter of people (26 per cent) did not know that unprotected sex between two men is a way of contracting HIV (this was 12 per cent in the 2000 survey). And thirty-one per cent of people did not state that sharing a syringe when injecting drugs carries a risk of HIV (this was 12 per cent in the 2000 survey).

This decline in knowledge will not come as a surprise to many people living with HIV or working in the field. Much has changed since the nineties when knowledge of HIV was significantly higher. Today, treatment that makes HIV more manageable also makes it more invisible. Furthermore, the public awareness campaigns of the 80s and early 90s have stopped. HIV is not a compulsory element of a school’s curriculum. Funding for HIV prevention has declined. And it is increasingly difficult to interest the media in the need for informative not sensationalist pieces about HIV. This lack of awareness and knowledge has worrying implications not just for HIV prevention but also for the establishment of a non-stigmatising society.

Over 90 per cent of the British public do not fully understand how HIV is transmitted.

This decline in knowledge does not however mean that efforts to inform and combat stigma over the past years have gone unrewarded. The research points to a number of positive steps forward in tackling stigma.

Specific initiatives by the National AIDS Trust and other organisations to educate employers about HIV and reduce workplace discrimination seem to have had impact. The survey found the majority (70 per cent) of people in the UK would feel comfortable working alongside a colleague with HIV. This is a marked increase of thirteen per cent from 2005 when just six out of ten (57 per cent) said they would be comfortable working with a colleague who has HIV. Only eight per cent disagreed with the statement in the latest research. And over seventy per cent recognise that people with HIV can work like anyone else, compared to sixty-six per cent in 2005. However, one worrying finding was that significantly more people in 2007 would expect to be told if one of their work colleagues was HIV positive (44 per cent compared to 36 per cent in 2005). It is not clear the reasons for which someone would expect to be told.

Support for people living with HIV was also apparent when people were asked if someone they knew was living with HIV would it affect their relationship with them. Most people claim that they would be supportive if someone they knew became infected with HIV. Almost three-quarters of people said that if a family member told them they had HIV it would not damage their relationship with them. The results are lower for a neighbour – with two-thirds agreeing that their relationship with them would not be damaged if they found out they were HIV positive. It is clear that the closer someone is to someone living with HIV, the more understanding they will be.

However the issue of support for people living with HIV is complicated by a culture of blame associated with HIV. Whilst the overwhelming majority of people are supportive - seventy percent of people asked believe that those living with HIV deserve the same level of support and respect as someone with cancer – almost half (48 per cent) state people who become infected with HIV through unprotected sex only have themselves to blame. Even more worryingly sixty-four per cent said that people who become infected with HIV through injecting drugs only have themselves to blame.

The messages from the Public Attitudes Towards HIV survey are mixed. Whilst a worrying gap in knowledge continues to grow, the vast majority of people have supportive attitudes to HIV and specific examples of this can be seen in the growing support for people living with HIV in the workplace. 4 However whether in the workplace, school or community at large it only takes one person’s stigmatising attitude to cause discrimination and potentially have a devastating effect on the life of someone living with HIV. It is clear more work needs to be done to create a fully inclusive society.

There are two specific challenges emphasised by this research. We need to invest more in education and public awareness of HIV. Results from this and other surveys show links between levels of knowledge and understanding and non-stigmatising attitude towards those living with HIV. We must continue to pressure the government to re-invest in educating the public about HIV.

And secondly we need to challenge the culture of blame that is so often targeted at people living with HIV. The survey shows us that understanding towards people living with HIV increases the more someone feels they can relate to someone with HIV so it is crucial we bring a more human face to HIV in the UK. Yet, addressing this challenge is perhaps the more difficult of the two. In order to tackle this stigma we need more people to speak out and share their stories but it is the same stigma that prevents people from speaking out in the first place.

For our part the National AIDS Trust will incorporate these lessons into our policy and campaigning work over the coming year. We will continue to educate employers on good practice around HIV refining our messages in light of the findings, to pressure the government to invest in information and awareness, to challenge stigmatising media coverage and to support those people living with HIV to speak out.
We are continuing to analyse the results from this important survey. We would also welcome your views on the wealth of information the survey has gathered. As all good surveys, this has raised as many questions as it does answers. The full report is available to download from our website www.nat.org.uk. We encourage you to comment and give us your views in feedback via the website. PN

Deborah Jack, Chief Executive, National AIDS Trust

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