HIV patients face lingering discrimination from doctors

This article is part of Telescope: The New AIDS Epidemic, a deep-dive investigation into the modern face of a disease that transformed the world.

Michael Jettmar was facing a problem he didnt expect to have after being diagnosed with HIV: He was struggling to make a dentist appointment.

An activist working for an NGO representing sex workers and living in Prague, Jettmar is required by Czech law to disclose his HIV status — and, it seemed, dentists didnt want his business.

“Every time, the woman at the reception said Ill call you back and ask the doctor if its possible,” he recalled. Each time, the answer was no. Instead, they recommended he visit an HIV center for treatment. One receptionist said it wasnt possible to treat his “kind.”

The process made him feel “dirty,” Jettmar said. He now goes to a town an hour away to get treated. He said he has to take a full day off at work because of the commute.

Jettmars experience highlights an uncomfortable reality for Europeans living with HIV. Decades after treatments were developed allowing those with the virus to live an almost normal life, the stigma attached to the disease persists — even among those charged with keeping people healthy.

Nearly one-third of HIV patients in Europe have reported cases of discrimination from doctors, nurses and other health care workers, according to a 2014 study looking at discrimination against people with HIV in health care.

Christiana Nöstlinger, a social scientist at the Institute of Tropical Medicine in Antwerp and the studys lead author, notes that discrimination is more likely to occur in “non-HIV specialized settings.”

Its among dentists, gynecologists and primary health care where “people are reluctant to even share their HIV status and disclose because of fear of discrimination,” she added.

Dentists come up often in stories of discrimination.

A survey of HIV-positive people in the Czech Republic, for example, found that 42 percent of respondents said theyd been denied dental care at some point, according to Robert Hejzak, chairman of the board of activist group Czech AIDS Help, which conducted the research.

The stigma also affects vulnerable groups disproportionately. “We see more people with LGBTI background, [as well as] men having sex with men, which are the biggest group, and migrants coming from high endemic regions, who are also confronted by racism,” said Nöstlinger.

Another study, from France, looked at the bias against different vulnerable populations with HIV. It found that women from sub-Saharan Africa reported the highest levels of discrimination. Straight non-African men reported the least.

Go west, young man

In Europe, bias against sexual minorities living with HIV among health care workers is alive and well in the west but is especially prevalent in the east. There, in some cases, more conservative attitudes mingle with the vestiges of the Warsaw Pacts stern and top-down approach to medicine.

The EU-LGBTI II Survey shows, for example, that in Poland, 58 percent of respondents always avoid holding hands in in public with their same-sex partner out of fear of being assaulted, threatened or harassed, closely followed by Romania and Croatia at 57 percent each. By contrast, Nordic countries like Finland and Sweden report 13 percent and 15 percent, respectively.

Theres also a lot of ignorance about the virus, said Karol Ludwikowski, a pizzeria employee from Poznan, Polands fifth biggest city. He came out as HIV positive in 2015.

“People — even my friends —began asking me if they could kiss me or touch me,” he said. “To me, that means any education about AIDS has been non-existent. Its been swept under completely. Its laughable and scary at the same time.”

Alex Schneider is the founder of Life4me +, an organization dedicated to battling discrimination and preventing the spread of sexually transmitted infections. Hes also a gay man living with HIV.

As a Russian of German descent, Schneider said he was initially committed to staying in the country where he was born. But he left for Germany in 2002, when he felt the situation was getting difficult to live in.

For him, Germany and Austria are examples of forward-thinking approaches to HIV treatment. As he sees it, the further you go east, the worst discrimination becomes, with Russia at the opposite end of the spectrum when it comes to treatment of the disease.

Schneider, who gathers instance of discrimination through his organization, said that while complaints from LGBTQ individuals are clustered in the east, its more common in the west for migrants to complain of bias. He said that the situation in Russia is particularly tough, forcing many people living with HIV to lie about their LGBTQ status due to fear of stigma.

“They say I have HIV because of sex with women,'” Schneider explained. “Theyre forced to lie because if you say youre gay … its your fault.”

In the big cities like Moscow and St. Petersburg, private, gay-friendly clinics have sprung up. Many LGBTQ people prefer to go there, paying not insignificant sums for their peace of mind, Schneider added.

Soviet legacy

Schneider also points a finger at the legacy of the countrys past approach to health. “The problem of the medical care system in Russia is its still the Soviet system,” Schneider explained. “And in the Soviet system, the doctor is God.”

“You feel like youre a child, and theyre parents,” he said. “They try to show they know better, and they show you that they are better than you because they dont have it. Thats really big pressure.”

“If you also say youre gay, you cant imagine the pressure you get,” he added. “I wouldnt do it, especially in a small city in Russia.”

Hejzak, of Czech AIDS Help, also blames the legacy of the past on the harsh treatment of LGBTQ individuals in his countrys health system. He views laws that require disclosure of HIV status to doctors, even for non-HIV related treatment, as responsible for holding back progress. In many Eastern European countries, these laws are still on the books.

“This is in contrast to Western Europe, which has by and large abolished similar rules,” Hejzak explained. “In Eastern Europe and the Soviet space, theres still this police mentality that you need to control everything, that the patient has no rights.”

While not as bad as Russia, the Czech Republic has its own issues with discrimination against the LGBTQ community, he added.

“None of the doctors publicly admit this … but theres a hidden stigma,” he said. “You can see it from tone that [they think] gay sex is immoral and they deserve it from way they behave.”

The Institute of Tropical Medicines Nöstlinger explained that stigma associated with HIV can Read More – Source

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