Academic journal article Social Work

Fear of AIDS and Homophobia: Implications for Direct Practice and Advocacy

Academic journal article Social Work

Fear of AIDS and Homophobia: Implications for Direct Practice and Advocacy

Article excerpt

Social workers are frequently called on to tend to the psychological, social, and other health-related needs of those affected by AIDS. However, concerns have been raised about the preparedness of social workers to deal with people with AIDS (PWAs). Studies have shown that social workers can be misinformed about AIDS, particularly about its effect on specific populations (Peterson, 1991). Although most social workers seem to be generally comfortable working with people who have AIDS, homophobia has been found in many who work with this group (Weiner & Siegel, 1990). In fact, a large percentage of social workers reported that they might even refuse to provide services to people with AIDS (Dhooper, Royse, & Tran, 1987-88). Apparently, the more social workers are concerned about contracting AIDS, the less comfortable they feel in serving HIV-infected people and PWAs.

Review of the Literature

The predominant attitude about people with AIDS or HIV infection has been negative and hostile. Herek and Glunt (1988) defined this reaction as "AIDS-related stigma" and described two sources of stigma: PWAs are stigmatized because AIDS is a contagious and incurable disease, and AIDS is associated with people already in stigmatized or oppressed groups -- homosexual people, intravenous drug users, and people of color.

Research indicates that attitudes about care and empathy are strongly affected by the individual's knowledge that the patient is homosexual. Personal beliefs and social sentiment about homosexuality may serve as catalysts to influence attitudes about this disease. Whether because of denial, misinformation, or lack of education, AIDS is still often regarded as a disease affecting gay people. Thus, it may be treated as a moral rather than a medical issue. Social workers are not alone in associating homosexuality with AIDS. Recent studies of college students (Larsen, Serra, & Long, 1990; St. Lawrence, Husfeldt, Kelly, Hood, & Smith, 1990) found that negative attitudes toward gay people were strongly associated with negative attitudes toward PWAs. A study of students training for careers in various health care professions (Kelly, St. Lawrence, Smith, Hood, & Cook, 1987; Royse & Birge, 1987) showed that their homophobia was inversely associated with empathy for PWAs. Men were more homophobic and reported greater fear of contracting the AIDS virus. Heterosexual men's homophobia was shown to surpass women's in a more recent study of college freshman as well (D'Augelli & Rose, 1990). Although calls for increased education are common, increased knowledge about AIDS is not necessarily followed by a reduction in homophobia or a lessening in the association between homophobia and fear of AIDS (Young, Gallaher, Belasco, Barr, & Webber, 1991).

These findings should provoke great concern for at least two reasons: First, many of these students are the human services and health care professionals of tomorrow. Second, providing students with accurate information about homosexuality and AIDS has been shown to have only a modest effect on their attitudes, beliefs, and behavior. Given that experience often provides a more direct route to psychological change (Bandura, 1977), one might speculate that people who have personal experience with a gay person or a person infected with HIV would also be less homophobic and less likely to fear a PWA.

Social workers should be concerned not only with inhibitions in treating homosexual or HIV-infected people but also with how homophobia and fear of AIDS affect their opinions about the civil rights of gay people. Evidence has demonstrated that politically and religiously conservative college students are more homophobic and fearful of AIDS than students who are generally liberal (Bouton et al., 1989). If homophobia and fear of AIDS are negatively associated with practitioners' views toward basic civil liberties, helping professionals may be less willing to advocate for those afflicted with this deadly disease. …

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