World AIDS Day

Today is World AIDS Day. There are so many things to say and so much that needs to be done -- more research, better access to treatment, eliminating the stigma associated with HIV/AIDS. HIV/AIDS is not just an epidemic because of its biological virulence. Cultural factors matter here -- women's disempowerment, sex tourism, sex trafficking, poverty, inadequate sexuality education -- all have to be addressed if we are to reduce the spread of HIV. But let me just take a moment to talk about one factor: sexual guilt and shame.

Shame and guilt surrounding sexuality are doing nothing to help contain this epidemic -- in fact, they only facilitate the spread of HIV. Guilt and shame lead to discomfort, silence, and denial.

Discomfort: Feelings of guilt and shame make us uncomfortable. So we become uncomfortable about sex -- unwilling to address it directly, speaking only in vague euphemisms. Uncomfortable going to get tested. Uncomfortable buying condoms. Uncomfortable using condoms -- research has found that those who feel guilt and shame about sex are less likely to use contraception consistently. Discomfort about sex doesn't stop people from having sex, but it does make them less likely to engage in safer sex. And when we are really uncomfortable, we don't want to talk about it at all, leading to . . .

Silence: When we feel ashamed or guilty about something, we don't want to talk about it. So we are less likely to talk to our partners about our sexual history (for example, men on the down-low). We are less likely to discuss testing with our partners prior to sex. We are less likely to negotiate safer sex practices with our partners prior to sex. We are less likely to talk to our children about sex, less likely to provide them with the comprehensive sexuality education they need to make educated decisions about their sexuality. And so silence results in the ignorance that continues the spread of HIV. It was this shame-based silence about HIV/AIDS that delayed any systematic response to the epidemic in the United States for so many years, and there is still a conspiracy of silence surrounding HIV/AIDS in many countries today.

Denial: We would rather not admit that we commit shameful acts. So if sex is embedded in shame, we try to deny our own sexuality. We don't admit to ourselves that we are sexually active -- which means we don't need to buy condoms, get tested, or talk to our partners. That doesn't stop us from having sex, but it means we are unprepared and more likely to engage in risky activities. When sex is considered shameful, government leaders deny the existence of stigmatized sexual activities (e.g., homosexuality, prostitution, sex trafficking) and go on to deny or minimize the issue of HIV/AIDS in their country.

I'm not saying that a shame- and guilt-free sexuality would cure AIDS or make HIV go away. But it would help us do what we can to protect ourselves, reduce the spread of the virus, and eliminate the stigma that it carries with it.