The study, conducted by Dr. Gregory Herek, a research psychologist at the University of California at Davis, used scientific telephone survey methods to ask a representative sample of more than 1700 American adults their opinions about people with AIDS and various AIDS policies.

"More than one American in four feels uncomfortable about being around a person with AIDS," Dr. Herek said. "And a large proportion of the population still doesn't understand that AIDS is not spread through casual social contact. Moreover, the extent to which people with AIDS are blamed for their illness seems to be increasing."

Approximately half of the survey respondents incorrectly believed that AIDS might be transmitted through sharing a drinking glass with a person with AIDS, being coughed or sneezed on, or using a public toilet. These figures represent a slight increase since 1991, when Dr. Herek conducted a similar survey. He speculates that the rise in the public's misinformation about HIV may be due to the fact that AIDS information campaigns in recent years have placed less stress on the safety of casual contact.

More than half of the survey respondents believed that most people with AIDS are responsible for having their illness. 29% agreed that people who got AIDS through sex or drug use have gotten what they deserve, compared to 20% who felt that way in 1991.

Dr. Herek regards these patterns as ominous signs.

"We know from past research that the public is more likely to stigmatize persons with AIDS to the extent that they believe that AIDS is easily spread and that people with AIDS should be blamed for their illness," he said. "As these perceptions increase, there is a real possibility that prejudice and discrimination against people with AIDS will also increase."

The study also indicates that the public still perceives AIDS as largely a gay disease, even though the epidemic is increasingly transmitted through heterosexual contact. In addition, gay and bisexual men with AIDS get more blame and less sympathy than heterosexual men and women with the disease, regardless of whether they were infected through sex with one or many partners.

The survey also shows that the public has little sympathy for people who contract AIDS through sharing needles for injecting drugs.
 

"An encouraging sign is that support for extremely coercive policies, such as quarantine and public identification of people with AIDS, has declined over the past decade," said Dr. Herek. He noted that 17% of the public now supports quarantine, and 19% would have the names of people with AIDS made public. In a 1991 national survey conducted by Dr. Herek, these policies were supported by, respectively, 36% and 30% of the US public.

In addition, fewer people today say that they would actively avoid social contact with a person with AIDS in the workplace or a neighborhood grocery store. Only 12% would avoid an office coworker with AIDS today, compared to 20% in 1991. 33% would avoid shopping at a neighborhood grocery store whose owner has AIDS, compared to 47% in 1991.

Even though these figures represent a decrease in some aspects of AIDS stigma, Dr. Herek notes that they should be lower still.

"As a society, we have been living with AIDS for more than 15 years," he observed. "We should have reached the point by now where no one would support quarantine or avoid a person because he or she has AIDS."
 

Dr. Herek believes that this widespread perception of stigma has important implications for AIDS policies. He suggested that advocates of mandatory reporting and contact tracing for people who test positive for HIV should consider the possible effects of such policies on those who are at risk for infection.

"People who expect to face persecution if they have HIV may be discouraged from being tested or seeking treatment if they believe that their name will be placed on a government list," said Herek. If mandatory reporting and tracing laws are to avoid discouraging high-risk people from being tested, he suggested, those people will need to be convinced that their civil rights and privacy will be vigorously protected.

Dr. Herek also stressed the importance of including anti-stigma messages in educational programs about AIDS.

"It is not enough simply to tell people how to avoid infection or get treatment," he said. "We also need to keep repeating the message that people with AIDS deserve our respect and compassion."
 

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