On November 17, 2019, a 55-year old individual in China became the first case of the now global disease, COVID-19. Fast forward to the present day and there are currently over 2.5 million deaths worldwide at the hands of this pandemic, according to data from John Hopkins University.
In a world of advanced technology and living conditions, mass death seems like a medieval or outdated narrative. In this sense, the COVID-19 virus came as a shock. However, while today’s generation may view this pandemic as unprecedented, older generations can remember another viral disease: AIDS.
Just 38 years prior to the world’s first COVID-19 case, five men in the US were found to have a rare lung infection. By the end of the year, there were 335 cases of ‘acquired immune deficiency syndrome’ from what we now know as the ‘human immunodeficiency virus.’
The HIV virus primarily spreads through bodily fluids, which is why the most common causes of transmission are unprotected sex and the sharing of intravenous needles contaminated with another person’s blood. AIDS is the disease caused by the HIV virus. In time, it cripples the body’s immune system, exposing its victims to other infections and even some types of cancer.
In the decades since its emergence, HIV-AIDS has become one of the world’s largest public health crises. Millions of people continue to live with the disease.
Although the virus can infect anyone regardless of gender or sexual orientation, men who have sex with men (MSM) are particularly vulnerable because anal intercourse is one of the easiest ways the virus can spread. At the same time, a lack of access to health care for MSM can make it harder to detect, and ultimately stop, infections. As a result, MSM still make up a high percentage of HIV cases.
The United States’ Centers for Disease Control and Prevention estimated that they made up 69 per cent of new HIV diagnoses in the United States in 2018. The Canadian figures are similar: the HIV advocacy organization Community AIDS Treatment Information Exchange (CATIE) used federal data to find that MSM accounted for just over half of all HIV-positive Canadians in 2018.
Despite the severity of AIDS symptoms, the tremendous success in drug development has helped HIV-positive people live longer, healthier lives — and yet stigma around the disease remains.
The comparison between COVID-19 and AIDS — and its limits
In a lot of ways, the AIDS epidemic and COVID-19 are very similar. After all, in the 1960s, AIDS spread from Africa, to Haiti, to the Caribbean, to New York, and then to San Francisco. This pattern of fast-moving global transmission is all too familiar today.
A smaller point of comparison is each virus’ effects on businesses. AIDS caused the shutdown of establishments marketed toward gay people such as clubs and bathhouses, and COVID-19 continues to close numerous small and non-essential businesses.
While the two share a similar profile in how they affected the global population, the AIDS crisis not only left death in its wake, but also a shocking portrait of a world ready to blame MSM for a disease to which they were disproportionately vulnerable.
A recent New York Times article comparing the homophobia that fueled the AIDS pandemic with stigma against those who flout public health restrictions during COVID-19 was heavily criticized on social media. The comparison was seen as downplaying the discrimination AIDS victims faced, as well as making light of risky behaviour that could endanger others during the COVID-19 pandemic. One Twitter user called the comparison “insanely offensive.”
COVID-19 has resulted in an unprecedented increase in anti-Asian hate crimes — in Vancouver, that figure went up by 717 per cent — but AIDS was stigmatized early on in a way that COVID-19 has not, since public health officials claimed that AIDS only affected MSM.
A key difference between the two viruses is that COVID-19 is transmitted more easily, as it does not rely on the exchange of bodily fluids like the HIV virus. Tracing the fear behind AIDS, a virus that is much easier to regulate than COVID-19, reveals a chilling story of discrimination.
Where did the stigma of AIDS start?
In 1982, health officials named the disease ‘GRID’ — gay-related immune defficiency — on the basis that it appeared to infect only MSM. As a consequence of this assertion, society started to link its existing moral judgments about gay individuals to its perception of the virus itself. In fact, the discourse often orientated around HIV being a disease that gay people brought upon themselves as a result of ‘risky’ or ‘unnatural’ sexual behaviours.
This assumption was dispelled in 1983 when reports of women partners of HIV-positive men who contracted the virus started to come out of the woodwork. However, despite the overwhelming evidence that sexual orientation and AIDS transmission were not directly correlated, it was still called the “gay plague” years later.
Today, there are more than 68,000 HIV-positive people in Canada. Advancement in HIV treatment and prevention has significantly improved, expanding an HIV-positive person’s life span from an estimated 39 years in 1996 to 70 years in 2011.
In addition to improved research about the virus, support for HIV-positive individuals has also increased. In 1989, a man named Giles Fontaine was fired from his job aboard a Canadian Pacific train after his managers learned of his HIV status.
In response to his wrongful termination, Fontaine launched a Canadian Human Rights Tribunal that ended with the company being found guilty. This landmark case settled the right of HIV-positive people in Canada to be accommodated by their employer, as is the case with other health conditions and disabilities.
A lingering stigma: employment discrimination
Despite improved knowledge about the virus, however, institutions continue to discriminate against HIV-positive people.
A recent study led by researchers at the University of Toronto revealed that employers would often find subtle methods to fire their HIV-positive employees. One participant in the study noted that, as a consequence of people being fired after employers found out their health status, they would “[see] people going back into the workforce and then going right back on the social assistance.”
Additionally, HIV-positive individuals often quit their jobs as opposed to taking time off for their health through the Employment Insurance sickness benefit. According to the researchers, this behaviour was motivated by a concern that applying for the benefit would disclose their health status to an employer.
Melissa Perri, a master’s student at the Dalla Lana School of Public Health and lead author of the study, wrote in an email to The Varsity, “Despite advocacy, research, and program planning over the years, we can still see negative perceptions and connotations surrounding HIV.”
One such perception is a misunderstanding of how AIDS is transmitted in the first place. A 2011 research study illustrated that an employer’s decision to interview someone with AIDS is contingent on their fear of contagion. Not only is this a gross misunderstanding of the virus’ mechanics — it is primarily a sexually transmitted, not airborne, virus — but, through their fear, employers reinforce the same moral judgments that were present in the 1980s.
Furthermore, even after securing an interview, many HIV-positive people would still be wary to accept a job for fear of co-worker discrimination or facing hate crimes — both situations that can severely damage an individual’s mental health.
All these factors contribute to unemployment among HIV-positive people, which varies between 45 and 65 per cent, according to studies from Canada, the United States, and France.
However, employment discrimination is not the only type of discrimination HIV-positive people face. HIV stigma is a systemic issue with wide impacts beyond the job sector. As Perri described it, “Perceptions surrounding, HIV have been engrained within our systems and institutions.”
For example, up until 2016, MSM could only donate blood in Canada if they remained celibate for five years. Even after the celibacy period was shortened to one year in 2016, and later to three months in 2019, researchers and members of the LGBTQ+ community have continued to describe the policy as discriminatory and outdated.
The surviving stigma of AIDS, almost 40 years after the virus’ emergence, highlights a lasting vulnerability that HIV-positive people feel, particularly in their employment. In their article, Perri and her team called for more proactive action from employers to reduce stigma. Perri clarified in her email that change should “include increased awareness to HIV related needs & care which ultimately should be led by [people living with HIV].”