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In their essay in Octobers PLoS Medicine Daniel Reidpath and Kit Yee Chan challenge the widely cited link between HIV-related stigma and the spread of the epidemic. This is an important question given the heavy emphasis on stigma in policies of the World Health Organization the Joint United Programme on HIV/AIDS and other public health institutions but in making their argument Reidpath and Chan misrepresent the connections that other authors have made between stigma and viral transmission ignore evidence that does suggest an association and propose a model of their own for which they offer no evidence. HIV infection establishes itself first in certain high-risk groups--men who have sex with men intravenous drug users sex workers mobile populations--and only later moves into the general population. In the early stages of the epidemic stigma facilitates transmission within high-risk groups because these already marginalized groups receive little attention from policy makers and the health-care community and are further discriminated against when they are identified with HIV and AIDS. (excerpt)

HIV, Stigma, and Rates of Infection: More Complicated than Reidpath and Chan Suggest