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HIV Care Approach
Changing the Medical Approach Toward People Living With HIV: A Patient Advocate’s Perspective

Released: October 10, 2022

Expiration: October 09, 2023

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Key Takeaways:

To improve the medical approach toward people with HIV, healthcare professionals should focus on the:

  • Importance of nondiscriminatory language and assertive communication
  • Right to life and dignified treatment
  • Need for a more human relationship and interaction

As a person living with HIV, an activist, and a sociologist, I have extensively studied the importance of nondiscriminatory language and assertive communication within clinical spaces to break down stigma and prejudice for people with HIV.

The Relationship Between Healthcare Professionals and People With HIV
HIV, like any other health condition, has social and cultural dimensions that, in practice, play an important role in the care of people who live with it. It cannot be understood solely and exclusively from the medical and clinical gaze. We also are talking about actions that occur in spaces such as the clinic and doctor’s office, as well as the relationship between people with HIV and healthcare professionals (HCPs). It must be recognized that there is a vertical power relationship where HCPs are attributed a certain form of unquestionable authority that, on many occasions, can cause moments of great discomfort, insensitivity, condescension, and aggression for us, the patients.

What People With HIV Experience in Their Lives
Behind this lies the right to life and decent treatment—that is, to dignity—which is asserted when it is recognized that people with HIV are people who feel and suffer. We enjoy, we live, and we have a history and an identity (or several). Starting from this, we must understand that we are neither carriers of biological weapons nor a danger to society. On the contrary, HIV is another experience in our lives that does not make us good or bad people, nor does it make us better or worse—but it does leave us in a situation of vulnerability in the face of a society that constantly judges and punishes behaviors, practices, lifestyles, and identities that deviate from the social and moral norm.

However, vulnerability is not the same as having no agency or autonomy over one’s actions. It is, on the other hand, recognizing the weight of structural factors of a social and economic nature—such as social class, ethnic/racial identity, gender identity, educational level, and sexual orientation—in people’s actions and decisions.

What Can Be Done to Improve the Medical Approach Toward People With HIV
It is very important not to polarize the relationship between one’s social vulnerability and autonomy, because in reality they are processes that coexist in the lives of people with HIV. I mention it because we are usually treated as passive beings with no agency, or—on the contrary—we often are blamed for living with the virus, for having some failure in our treatment adherence, or for developing some disease, even if it has nothing to do with HIV. Health is not only an act of individual responsibility, but neither is it an exclusive matter of social assistance.

I propose a more human and empathic view where, although the relationship between people with HIV and HCPs may not always be completely horizontal, there may be a more human relationship and interaction, where the right to a dignified life for people with HIV is prioritized under the understanding that the virus does not make us less—it just makes us different.

As Foucault argued in The Birth of the Clinic, we live in societies where medical thought has been imposed on, and therefore compromises, the philosophical status of the human being. I think it is important to bet on a new way of understanding that status and to build a society free of stigma and discrimination against people who live with HIV, including—of importance—from HCPs.

Your Thoughts?
What do you think can be done by HCPs to improve the medical approach toward people with HIV? Join the discussion in the comments section.