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Tourism and HIV

Involving Women in the Design of Educational Materials in Rural Costa Rica

Nancy Romero-Daza, Mackenzie Tewell, David Himmelgreen, Oriana Ramirez-Rubio and Elsa Batres-Boni

This article describes the involvement of women from rural Costa Rica, where tourism is predominant, in the creation of HIV/AIDS awareness materials that are appropriate for families and peers. The project was conducted in four towns in the Monteverde Zone, a region that has experienced a transition from an economy based on agriculture and dairy farming, to one dependent on tourism. Informed by previous research that shows the signi ficant impact of tourism on the economic and social landscape of the zone, this project responded to local residents' desire for participatory approaches to raise awareness about the potential spread of HIV/AIDS in their communities.

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The GIPA Concept ‘Lost in Transition’

The Case of Expert Clients in Swaziland

Thandeka Dlamini-Simelane

As I sit in the waiting area outside an HIV (human immunodeficiency virus) counselling room in a rural clinic in Swaziland, many people walk in and out – young and old, frail and agile. Some enter the counselling room looking distraught and leave

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The Marketization of HIV/AIDS Governance

Public–Private Partnerships and Bureaucratic Culture in Pakistan

Ayaz Qureshi

The World Bank-financed 'Enhanced HIV and AIDS Control Program' tried to reorganize HIV/AIDS governance in Pakistan by pushing a neoliberal agenda, marketizing the provision of publicly funded HIV prevention services. NGOs and the private sector competed for contracts with the government to provide services to sex workers, drug users, transgendered people and homosexuals who were deemed 'high risk' groups for HIV. With this contractualization emerged a new bureaucratic field that emphasized 'flexible organization' and 'efficiency' in getting things done in place of the traditional bureaucratic proceduralism characteristic of the Pakistani civil service. This new corporate-style bureaucratic culture and the ambiguities of a hastily contracted (and 'efficiently' rolled out) Enhanced Program meant public funds ending up in the pockets of a few powerful actors. Instead of generating more efficiency, the marketization of services dispossessed the intended beneficiaries of the World Bank loan.

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Community Participatory Research in HIV/AIDS Prevention

An Exploration of Participation and Consensus

Jon Poehlman

This article reports on an investigation into the extent to which individual involvement in community participatory research activities on HIV/AIDS created agreement or consensus among participants from four Malawian communities about the causes, risks, and behaviours associated with AIDS transmission in their communities. In this research, cultural consensus analysis was used in an exploratory manner to measure the level of agreement among participants prior to and immediately following participation in community participatory workshops. The results demonstrate variability by community and gender in the levels of consensus, or agreement, achieved through the workshops. These findings suggest that consensus is not an automatic outcome of participation in small group interventions and in some cases can result in less agreement on community issues around HIV. Moreover, we lack a clear understanding of how consensus contributes to desired or positive change. Also discussed is the potential utility of cultural consensus analysis as a tool in evaluating the effectiveness of community participatory interventions.

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Josiane Tantchou

The aim of this study was (a) to use anthropological research tools to produce a thorough description of health providers' working conditions in a low-income country; (b) sketch the impact of a specific dimension of the national HIV/AIDS programme on this environment and (c) sketch the existence and examine the extent of burnout among health workers. We conducted intensive fieldwork in a large public hospital in one major town of the far-north region. We relied on three research tools: observations, in-depth interviews and the Maslach Burnout Inventory (MBI). The data were analysed manually. We found a working environment characterised by an acute lack of equipment, lack of recognition and equity, lack of community and fairness, and value conflict, all of which are factors implicated in burnout. This was exacerbated by the implementation of a psychosocial dimension in care for people with HIV/AIDS, which created exclusion and reinforced feelings of unfairness. However, despite their challenging working environment, health-care providers were not 'burned out', leading us to suggest that burnout is a syndrome of 'rigid' working environments, as opposed to 'porous' working environments.

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Katie MacEntee, Lukas Labacher and John Murray

Young people use activism to advocate for their sexual health rights and to counter the social, political, and environmental threats to their health and well-being. By fully integrating themselves into the process of civic engagement—by incorporating pieces of themselves—youth can bring about successful change. Young community members can use civic engagement to speak out about their perceptions of how they are aff ected by health-related issues or how they are stigmatized by the community. In doing so, they are able to counter the ways in which policymakers, often distanced from the ramifi cations of inadequate social policy, portray the issues (Shucksmith and Hendry 1998). An interactive photo project that took place at the 2010 International AIDS Conference in Vienna, Austria, shows how civic engagement or what we think of as speaking out can move beyond rallies and online video and audio messages directed at policymakers and into the realm of digital photography and body language. Surprisingly, in a digital world in which body language and body parts are continually at risk of being sexualized, this interactive project illustrates how digital photographs of girls’ hands can be used to speak out in a positive, creative, and empowering way about girls’ and young women’s perceptions of sexuality and HIV.

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Social Sensations of Symptoms

Embodied Socialities of HIV and Trauma in Uganda

Lotte Meinert and Susan Reynolds Whyte

pursue here. The material we explore in this article comes from separate research projects 1 in Uganda on two different conditions: HIV in central and eastern Uganda and trauma (and cen spirits) in the Acholi region of the north. These are illnesses

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Women and Sexuality in Contemporary Iran

When HIV Meets Government Morality

Kristin Soraya Batmanghelichi

In Iran, as in many countries worldwide, misinformation and ignorance of HIV/AIDS have encouraged a culture of secrecy and anonymity for those living with HIV. For many HIV-positive women, religious, political and economic pressures complicate their social status and access to health care. Moreover, they must contend with societal discrimination and stigmas associated with the condition. Adding nuance to contemporary studies on gender and sexuality in Iran, this report highlights the colourful narratives of a select group of HIV-positive mothers attending weekly wellness workshops in Tehran. Discussing issues of intimacy, modesty, motherhood and stigmatisation, this article explores one of Iran's expanding communities at risk of infection and the ways in which women with HIV negotiate the stigma of their condition in an Islamic Republic.

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Through Our Eyes

Using Photovoice to Address Stigma in the Age of AIDS

Learning Together Project

Learning Together Project

Th e photographs in this essay were taken by grade eight and nine girls in one rural school in KwaZulu-Natal, South Africa in response to the question: What is the face of stigma in our community in the context of HIV and Aids? Th e girls used inexpensive point-and-shoot cameras to document the issues on location at their school, staging scenes that tell critical stories of the impact of stigma on the community. Once they had taken the photographs they developed captions which speak to the issues that they were working to represent. Some wrote in isiZulu while others chose to write in English. Th e isiZulu captions were translated into English. The images in this photovoice project help to identify, understand and interpret incidents related to stigma and discrimination against people living with, and aff ected by, HIV and AIDS.

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William W. Darrow

Public health in the United States has lost its edge. It made a significant impact on human well-being, capacities, and potential in the late nineteenth and early twentieth centuries. Now it takes a backseat to biomedical research and therapeutic medicine. Population health with its traditional emphasis on preventing harm has been displaced by an exorbitantly expensive and continually expanding medical care system devoted almost exclusively to restoring or rehabilitating the health of patients – no matter the cost. The failure to control the spread of human immunodeficiency virus (HIV) in the United States can be attributed to adherence to an inadequate biomedical model that ignores the social. Social quality theory, designed to further social justice, solidarity, equal value, and human dignity, can contribute to identifying and correcting deficiencies in biomedical approaches to HIV prevention and other public health problems that continue to plague the people of the United States.