Shana Cozad from Tulsa, OK, was a 22-year-old college sophomore with a 2-year-old son. She had decided that she wanted to end her relationship with her boyfriend, but when she finally told him, she got a response that came out of nowhere. “He said I couldn’t break up with him because he had AIDS. He said that he had chosen me as the person he wanted to die with.”
Cozad was taken totally off guard by her boyfriend’s admission, yet strangely, in retrospect, she was not overly alarmed. After all, “How could he have AIDS?” she asked herself. “He doesn’t look sick.” Besides, she thought, AIDS happened to “other people who had multiple partners and were not responsible like me. I had asked him the ‘right’ questions.”
Encouraged by a friend, Cozad went to her college clinic to be tested for HIV. A week later, the school nurse cried when she told Cozad that she was HIV-positive. There were soon additional tests, and they showed that her infection had progressed to AIDS. Frightened, Shana reached out to her family. “They were embarrassed and didn’t want to talk to me,” she recalls. “My mother essentially said, ‘Good luck, you’re on your own.’”
The year was 1992, and by that time legions of people infected and affected by HIV/AIDS had experienced the kind of rejection that Cozad received from her family. There had already been 11 years’ worth of discrimination, cruelty, abandonment, and unnecessary suffering for people living with HIV/AIDS (PLWHA), caused by the enormously complex phenomenon known as stigma. For more than a decade, people had lost jobs and health insurance coverage, been kicked out of apartments, and been shunned by family and friends. The stigma of HIV/AIDS caused people to be denied care by doctors, nurses, and the very institutions whose first charge is to do no harm. The result? PLWHA were often isolated. They endured untold emotional and physical suffering. Stigma—both external and internalized—led to many people dying in misery and solitude.
Cozad’s story would turn out differently. When she was diagnosed with HIV/AIDS, the Health Resources Services Administration (HRSA), HIV/AIDS Bureau’s (HAB’s) Ryan White HIV/AIDS Program was almost 2 years old. It had been designed to help and support people just like her. Cozad found a caring group of providers and fellow patients at the local Ryan White-funded HIV clinic. Instead of rejection and abandonment, Cozad encountered the compassionate, affirming, and supportive approach to care that is a hallmark of the Ryan White HIV/AIDS Program. The stigma-defying environment she encountered motivated her to stay in care. Ultimately, it also saved her life.