Shame & HIV: Strategies for addressing the negative impact shame has on public health and diagnosis and treatment of HIV

Hutchinson, P and Dhairyawan, R (2018) Shame & HIV: Strategies for addressing the negative impact shame has on public health and diagnosis and treatment of HIV. Bioethics, 32 (1). pp. 68-76. ISSN 0269-9702

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Abstract

There are five ways in which shame might negatively impact upon our attempts to combat and treat HIV, which emerge from the stigma HIV carries and STI-stigma in general. 1. Shame can prevent an individual from disclosing all the relevant facts about their sexual history to the clinician. 2. Shame can be a motivational factor in people living with HIV not engaging with or being retained in care. 3. Shame can prevent individuals from presenting at clinics for STI and HIV testing. 4. Shame can prevent an individual from disclosing their HIV (or STI) status to new sexual partners. 5. Shame can serve to psychologically imprison people, it makes the task of living with HIV a far more negative experience than it should, or needs to, be. Drawing on recent philosophical work on shame, and more broadly on work in the philosophy and psychology of emotion, we (a.) propose a framework for understanding how shame operates upon those who experience the emotion, (b.) propose a strategy for combatting the negative role shame plays in the fight against HIV, and (c) suggest further study so as to identify the tactics that might be employed in pursuing the strategy here proposed.