The ACLU AIDS Project: Decades On, Still Separate and Unequal

More

Unfounded fears echo throughout policy, health care, education -- pretty much everywhere.

3597048798_c0d6870e15_z615.jpg
ASurroca/Flickr
Essays and ideas to mark the 24th annual World AIDS Day See full coverage

Stigma associated with HIV is still far from a thing of the past. Legal cases against employers, health care providers, prison systems, and even the TSA, continue to keep attorneys busy with the American Civil Liberties Union AIDS project.

A decision is now pending in the ACLU's case against the state of Alabama. Just before Thanksgiving, a federal judge in the state delayed his ruling on whether Alabama will continue to be one of only two states in the nation to segregate HIV-positive prisoners.

To ameliorate its concern about the spread of HIV behind bars, the Alabama Corrections Department requires inmates who test positive for HIV -- every new prisoner is tested at intake -- to live in separate single-sex dormitories.

30 years into the HIV epidemic, 1 in 3 Americans gave wrong answers about three ways in which HIV is not transmitted -- sharing a drinking glass, touching a toilet seat, and swimming in a pool.

Prisoners living with HIV are required to wear white plastic armbands identifying them as HIV-positive. They are not allowed to hold jobs around food, and can't participate in the work-release programs with fast-food restaurants that employ HIV-negative inmates. They were not allowed to attend prisonwide church services until 2009.

Alabama and South Carolina are the only remaining states that segregate HIV-positive prisoners. Most states changed their isolation policies as knowledge about HIV prevention and treatment increased. A federal court upheld Alabama's policy in 1995, the year that effective medical treatment first became available to manage HIV infection. The Justice Department in 2010 notified South Carolina it was investigating and might sue to end the state's HIV segregation policy.

In September, the ACLU brought the class action accusing the state of Alabama of violating the Americans with Disabilities Act, which requires accommodation of people with disabilities -- not segregation or the stigmata of white plastic armbands. "We had the testimony of dozens of witnesses speaking about the practical harms of that policy," said Rose Saxe, a senior staff attorney with the ACLU AIDS project. She called it "incredibly stigmatizing."

The ACLU's more typical cases involve HIV-positive people excluded from jobs in which they pose no threat of transmission, or excluded from medical or dental services. "We worked with a nurses aide," said Saxe, "who was suspended after her supervisor found out she had HIV. She wasn't helping with surgery; she was helping people get dressed."

For those on the receiving side of medical services, Saxe said, "We see clients and members of the public being discriminated against whether going to a doctor or an eating disorder clinic, being told 'We don't work with people with HIV' or 'You can't stay in our facility; you need a special facility, and your insurance doesn't cover it.'"

When HIV-positive employees have revealed their HIV status, some employers have overstepped their legal bounds by demanding intimate medical information that goes far beyond their need or right to know. Said Saxe, "We are contacted by people who have to really justify keeping their jobs by answering invasive questions about their medical history or their viral load, when what they're doing doesn't present any risk. We were seeing demands for a person's viral load when their HIV had nothing to do with their job." She recalled the case of a man who applied to be a TSA baggage handler. "They asked his T-cell count," said Saxe. "They said he wasn't qualified because he could get sick working in an airport."

Saxe said most discrimination "is about a lack of understanding about transmission risk." She noted that the Kaiser Family Foundation's 2011 survey of Americans' attitudes toward HIV found that, thirty years into the HIV epidemic, 1 in 3 Americans gave wrong answers about three ways in which HIV is not transmitted -- sharing a drinking glass, touching a toilet seat, and swimming in a pool with someone who is HIV-positive.

Not only that, but 45 percent of Americans still report being uncomfortable with the idea of having their food prepared by someone who is HIV-positive, 36 percent with the idea of having an HIV-positive roommate, 29 percent with having their child in a classroom with an HIV-positive teacher, and 18 percent working with someone who has HIV.

The survey suggested that knowing someone with HIV, and knowing how HIV is and isn't transmitted, correlate to greatly reduced discomfort and the stigma and discrimination that results from it.

"We've come a tremendous way," said Saxe, "but it's sobering still to have to struggle with these kinds of scenarios."

Jump to comments
Presented by

The author of Victory Deferred, John-Manuel Andriote has specialized in HIV/AIDS reporting since 1986. His research materials, correspondence, and recorded interviews are part of a special collection curated by the Smithsonian.

Get Today's Top Stories in Your Inbox (preview)

Video

More Video
Here's What Happens When You Light a Fire in Space


Elsewhere on the web

Join the Discussion

After you comment, click Post. If you’re not already logged in you will be asked to log in or register. blog comments powered by Disqus

Video

Miami: The Next Big Start-Up City?

How the city became a center for innovation

Video

Video

A Brief History of Romantic Comedies

From The Atlantic's Chris Orr

Video

Life in 'the New Arctic'

A moving portrait of a fading landscape

Video

Video

The Rise of New York City

A fascinating look at Manhattan in the 1940s

Video

What Is Methane Hydrate?

"Flaming ice" is a vast natural energy source

Video

NASA's Time-Lapse of the Sun

Now with epic dubstep music

Video

Shaken Not Tuned: Cocktail Experiments

Can a tuning fork improve a cocktail?

Video

Video

Is He Cheating? A 1950s Guide

'That little blonde secretary from the office?’

Video

New Yorkers: Vintage Vacuum-Tube Amps

Risking electric shock to restore old amplifiers

Video

The DIY Piano-Bicycle

Everybody needs a hobby

Video

What Does It Take to Make Real Craft Gin?

Tour the Green Hat Gin distillery

Video

What Straights Can Learn From Same-Sex Couples

New insight from decades of research

Video

The End of the Mall Rat

A tribute to that pillar of teen culture

Video

The Wonderful World of Capitalism

An adorable 1950s cartoon

Video

New Yorkers: Miss New York USA

An unconventional beauty queen.

Writers

Up
Down

More in Health

In Focus

Early Monsoon Rains Flood Northern India

Just In