Infante C, Zarco A, Cuadra SM, Morrison K, Caballero M, Bronfman M, Magis C

Language: Spanish
References: 24
Page: 141-150
PDF size: 140.12 Kb.

ABSTRACT

Objective. To analyze the social construction of stigma and discrimination processes associated with HIV/AIDS and people living with HIV/AIDS (PLHA), based on the perceptions of health care providers in three states of the Mexican Republic. Material and Methods. Qualitative and quantitative description. Observation at nine institutions; in-depth interviews (14) and surveys (373) directed to providers of health services. Results. Seventy-five percent of providers reported having received training related to HIV/AIDS; however, notions persist as to patients being hopeless; discrimination due to the idea of risk groups; the immediate identification of living with the virus, having the syndrome and death; and specific lack of knowledge of forms of transmission. Twenty-three percent would not buy food from a PLHA and 16% think they should be banned from public services. With respect to confidentiality: 89% believe it should be maintained and 38% think that employers and administrators have the right to know about their employees’ condition. Isolation, notes in clinical histories pointing to HIV, obligatory testing and delays in surgeries for PLHA were constant practices. The perception that men who have sexual relations with men and sexual workers decide their sexual practices marks the division between innocent victims and guilty ones, which determines the stigmatization and discrimination processes in health services. Conclusions. The design of strategies to decrease stigma and discrimination associated with HIV/AIDS demands the inclusion of an ethical debate about human rights and a structural focus regarding social conditions that go beyond the notion of risk behaviors.

REFERENCES

1. Bronfman M, Castro R, Zúñiga E, et al. “Hacemos lo que podemos”: los prestadores de servicios frente al problema de la utilización. Salud Publica Mex 1997;39:546-553.

2. Goffman I. Stigma: notes on the management of spoiled identity. New Jersey: Prentice Hall, 1963.

3. Emily M. Medical metaphors of women bodies: menstruation and menopause. Int J Health Serv 1988;18(2):237-256.

4. Parker R, Aggleton P. HIV and AIDS-related stigma and discrimination: a conceptual framework and implications for action. Soc Sci Med 2003;57:13-24.

5. Bertaux D. Los relatos de vida en el análisis social. En: Aceves J (comp.). Historia oral. México: Universidad Autónoma Metropolitana, 1993:136-148.

6. Robson C. Real world research. Oxford: Blackwell Publishers Ltd, 2002.

7. Blumer H. Symbolic interactionism. Perspective and Method. New Jersey: Prentice Hall, 1969.

8. Strauss A, Corbin J. Basic of qualitative research: grounded theory, procedures and techniques. Newbury Park, California: Sage, 1990.

9. Lee R. Internalized stigma among people living with HIV-AIDS. AIDS Behav 2002;6(4):309-319.

10. Fife BL, Wright ER. The dimensionality of stigma: a comparison of its impact on the self of persons with HIV/AIDS and cancer. J Health Soc Behav 2000;41(1):50-67.

11. García DI, Ramírez-Valles J, Valbuena N. “...it’s a secret we have to keep”: measuring HIV/AIDS stigma among Latino gay men. Abstr Book 2003 Natl HIV Prev Conf July 27 30 2003. Atlanta, GA. (abstract no. T3-A1302).

12. Green G. Attitudes towards people with HIV: are they as estigmatizing as people with HIV perceive them to be? Soc Sci Med 1995;41:557-568.

13. Green G, Platt S. Fear and loathing in health care settings reported by PLWA. Sociol Health Illn 1997;19:70-92.

14. Goffman E. La presentación de la persona en la vida cotidiana. Buenos Aires: Amorrortu Editores, 1981.

15. Dworkin J, Albretch G, Cooksey J. Concern about AIDS among hospital physicians, nurses and social workers. Soc Sci Med 1991;33:239-248.

16. Kunzel C, Sadowsky D. Predicting dentists perceived occupational risk for HIV infection. Soc Sci Med 1993;36:1579-1584.

17. Taerk G, Gallops RM, Lancee WJ, et al. Recurrent themes of concern in groups for health care professions. AIDS Care 1993;5:215-222.

18. Farmer P. AIDS and accusation. Haiti and the geography of blame. Berkeley: University of California Press, 1992.

19. Sontag S. El SIDA y sus metáforas. Barcelona: Muchnik Editors, 1988.

20. Muñoz M, Cano F. Los derechos de las personas con síndrome de inmunodeficiencia adquirida. SIDA-VIH. México DF: Cámara de Diputados LVIII Legislatura, 2001.

21. Herek GM. AIDS and stigma: a conceptual framework and research agenda. AIDS Public Policy J 1998;13:36-47.

22. Malcom A, Aggleton P, Bronfman M, et al. HIV-related stigmatization and discrimination: its forms and contexts. Crit Public Health 1998;8:347-370.

23. Bourdieu P. Language and symbolic power. Cambridge: Polity Press, 1985.

24. Foucault Michel. Microfísica del poder. Madrid: La Piqueta, 1978.