24187: Craig (pub) Understanding and Addressing AIDS-Related Stigma (fwd)

[Bob Corbett <corbetre@webster.edu>]

From: Dan Craig <dan@bimini.ws>

Understanding and Addressing AIDS-Related Stigma: From Anthropological
Theory to Clinical Practice in Haiti"

American Journal of Public Health Vol. 95; No. 1: P.53-59 (01.05)::Arachu Castro, PhD, MPH; Paul Farmer, MD, PhD

The authors reviewed literature from anthropology, sociology and public health, and preliminary data from research in rural Haiti, "to question the understanding of AIDS-related stigma and to assess its relationships to integrated HIV prevention and care."

The researchers proposed structural violence as a conceptual framework for understanding AIDS-related stigma, pointing out that forces such a racism, sexism, political violence, poverty and other social inequalities rooted in historical and economic processes shape the distribution and outcome of HIV/AIDS. "Structural violence predisposes the human body to pathogenic vulnerability by shaping risk of infection and also rate of disease progression," the researchers noted. "Structural violence also determines who has access to counseling, diagnostics and effective therapy for HIV disease. Finally, structural violence determines, in large part, who suffers from AIDS-related stigma and discrimination."

The authors found, from their experience providing health and social services in rural Haiti, that stigma, treatment costs, lack of infrastructure and poor patient adherence to drug regimens do not constitute insurmountable barriers to effective AIDS control, despite claims by some public-health experts.

The authors point out that years before the advent of effective HIV/AIDS therapy, anthropologists noted that introducing such therapy might alter the social interpretations of the disease. "The social experience of AIDS is affected profoundly by the advent of effective therapy," the researchers noted.

"The introduction of antiretrovirals has had a profound and positive impact on the demand for voluntary counseling and testing," the investigators found. "Since 1998, when we introduced the first free and comprehensive AIDS program in rural Haiti at the Clinique Bon Sauveur, demand for such services has more than quintupled."

"The Haiti experience suggests that improving clinical services can raise the quality of prevention efforts, boost staff morale and reduce AIDS-related stigma," the authors noted.

"Rather than stigma, logistic and economic barriers determine who will access such services," they concluded.


>From the CDC News Update 02/01/04
http://www.cdcnpin.org






-- 
Daniel Craig
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