When my partner discovered that I had never seen “Sex and the City,” he immediately made it his sworn duty to rectify the situation. If you haven’t seen the show, it really is hilarious. It tells us the story of Samantha, Charlotte, Miranda, and Carrie as they navigate metropolitan life with all of its loves and losses. Charlotte is a conservative art dealer. Samantha is a successful public relations professional. Miranda is an always sarcastic and frequently pessimistic lawyer. Narrating the series is Carrie, a witty newspaper columnist whose daily life serves as subject matter for her column.
None of the ladies have many lonely nights, unless it’s by choice. Some romantic interests are series regulars while others are guest stars. In an episode I recently saw, Samantha is in the beginnings of a hook up with a man who asks about her last HIV test. “Anyone who has as much sex as us has to ask,” he says. Samantha completely panics, as she now finds herself reflecting on her very vibrant sex life and the potential for problems that she previously had not considered. She is forced to admit that she has never had an STI/HIV test, a truth that would also shock her girlfriends as they talked about the incident over coffee.
Samantha opens up a bit about her anxiety around getting tested, stating that “sometimes it takes me a really long time to get over a cold.” Carrie assures her “that’s not AIDS that’s central air conditioning.” Despite the jokes woven through the conversation it paints a realistic picture of the impact of stigma when it comes to HIV testing and prevention.
Miranda is shocked that Samantha has never been tested, because Samantha is so open about her sex life. Miranda also speaks to the experience of waiting for the results. Her description was reminiscent of the early days of COVID testing when a positive result got you escorted into a small side room to receive this life altering news.
Charlotte demonstrates a rather dangerous approach to HIV/STI’s. She doesn’t want to talk about it at all. As the ladies discuss the issue in the café, Charlotte is going through bridal magazines searching for the perfect gown. She makes it very clear that she will not be engaging such a discussion when such more pleasant topics were – quite literally – on the table.
Given what I do for work, I was pleased to see the girls having this very honest and open conversation about STI testing. A primary focus of the show is their sex lives, and frequently changing partners. The inclusion of this “b-plot” ended up an unintended dissertation on the effects and dangers of stigma.
All of the girls’ viewpoints were shaped by stigma. Miranda’s terrifying description of the testing process feeds the fear that so many people have already about getting tested. Charlotte’s desire to ignore the issue entirely is a common response to an illness that for many people is shrouded in mystery and affiliated with “risky behaviors.” Carrie in the meanwhile tries to ground Samantha in reality.
Would this episode even make sense if it were to air for the first time today, 25 years later? I would certainly hope that in 2025 Samantha would be aware that she can be on PrEP, which will essentially ensure that she does not contract HIV through a sexual encounter. I hope that there would be many options for testing, including clinics that are welcoming and inclusive. I hope that when she did go in for her HIV test, that she would be told that if the test came back positive she could still be a happy, healthy person. I hope that she would know that if her viral load got down to an undetectable level she would not be able to pass the virus to others.
In truth, however, even in 2025 there are still a great many Samantha’s still out there! There are gay and straight Samantha’s, white and black Samantha’s, male, female, and transgender Samantha’s. There are people of every walk of life who still have not heard these important messages! The impact of stigma remains very real, both in treatment and prevention and also in the lives of people living with HIV. We all can do our part in breaking down stigma each day in very simple ways.
We can make HIV/Sexual Health a routine aspect of our own healthcare, and talk about it as such!
We can model appropriate language when talking about HIV that helps eliminate long held, incorrect beliefs about HIV and other STI’s.
We can educate ourselves so that we can represent the HIV community accurately in our conversations.
The collective impact of stigma can cripple progress if we allow it. However, if we are intentional in our efforts, our collective impact can move us past the barriers formed by stigma. If we can do that, we just may be able to beat this thing.