"HIV/AIDS is not merely a medical problem: the
manner in which the virus is impacting upon society reveals the
intricate way in which social, economic, cultural, political and
legal factors act together to make certain sections of society more
vulnerable. The epidemic exposes the method and the impact of
marginalisation and inequality in clear terms.
Marginalised groups in our society have little or no access to
basic fundamental and Human Rights such as food, medical services
and information. Many of these groups are ostracised by society at
large, and their lifestyles criminalized, making it practically
impossible for them to participate in mainstream processes whereby
they could demand their rights. Coupled with this dismal situation,
there is minimal awareness about HIV and no real options for safer
lifestyles. The stark reality of the HIV/AIDS epidemic is thus that
people are becoming HIV positive because they have no access to
basic fundamental Human Rights. For the same reasons, the impact of
infection is a lot graver for those with no access to rights. It is
time to recognise this link between marginalisation, Human Rights
and vulnerability.
It is also time to recognise that the HIV/AIDS epidemic itself
has given rise to a range of Human Rights violations. The refusal of
treatment, denial of access to essential drugs including
antiretroviral therapy, discrimination in the health care and
employment sectors, women being deprived of their rights and thrown
out of their homes etc are just some examples of these violations.
Apart form having a serious impact on the lives of people living
with HIV, these violations are pushing the epidemic underground.
Unless these Human Rights violations are addressed, there cannot be
the creation of an enabling environment, where people come forward
to access health and other services, or even get tested.
There is also a need to understand the exact manner in which
factors of gender, caste, region, class, sexual orientation
influence the impact of these Human Rights issues for different
sections of society. Along with social and economic factors, there
are laws, which complicate the influence of these factors. To
understand these different contexts would be the first step in
addressing the problems they entail." Report of the National
Conference on Human Rights and HIV/AIDS
|
Marginalised Populations
|
India has
3.86 million people living with HIV/AIDS, the
highest in any country after South Africa. HIV in India is
mainly transmitted through heterosexual contacts placing large
parts of the population at risk of infection. The stigma
surrounding HIV/AIDS, and certain vulnerable groups affected
such as injecting drug users, often leads to discrimination,
which constitutes a serious obstacle to HIV/AIDS control and
management. |
|
|
Mobilising Media Activism and Community Participation in Stigma
Reduction |
the project
aims to harness the capacity of the Nigerian media and
communities as a potential force for change to reduce the high
levels of HIV-related stigma and discrimination in the country |
|
|
Neighborhood stigma and the perception of disorder |
Many
Americans hold persistent beliefs linking blacks and other
disadvantaged minority groups to social images, including crime,
violence, disorder, welfare, and undesirability as neighbors.
These beliefs are reinforced by the historical association of
involuntary racial segregation with concentrated poverty—in turn
linked to institutional disinvestments and neighborhood decline.
Stereotypes about race, poverty, and disorder may loom
especially large when residents have uncertain or ambiguous
information about the neighborhood as a whole. In poor
neighborhoods, many activities that in better-off neighborhoods
occur in private (e.g., drinking or hanging out) necessarily
take place in public. The resulting social structure of public
places reinforces the assumption that disorder is a problem
mainly in poor, African American communities. This stereotype
may lead to actions by members of the stigmatized group that
seem to confirm the statistical association between race and
social disorder, usually inextricably linked, in a kind of
developmental sequence. . .
|
Pdf 392 kb |
|
New challenges: HIV/AIDS and drugs |
Misconceptions about HIV/AIDS have led in some parts of the
world to an increased demand for young sex partners, including
very young children. In addition to the fallacy that children are
less likely to contract and transmit HIV/AIDS, in some countries
of Asia these are long-established myths about the rejuvenating
powers of youth.
|
82 kb pdf |
|
On Stigma and its Public Health Implications
|
One of the
curious features of literature concerning stigma is the
variability that exists in the definition of the concept
(Stafford and Scott 1986). In many circumstances investigators
provide no explicit definition and seem to refer to something
like the dictionary definition ("a mark of disgrace") or to some
related aspect like stereotyping or rejection (e.g. a social
distance scale). When stigma is explicitly defined many
commentators turn to Goffman quoting his definition of stigma as
an "attribute that is deeply discrediting" and that reduces the
bearer "from a whole and usual person to a tainted, discounted
one" |
|
|
Overcoming the stigma of chronic illness-Strategies for
‘straightening out’ a spoiled identity |
This paper
addresses the concept of chronic illness as a socially
constructed experience of stigma. The stigma of having a
chronic illness affects the person’s self-concept, capacity to
adapt to the illness and the quality of his/her social
networks. Social stigma is a de-legitimizing social process
derived from both popular and medical views of chronic illness.
Based on research into the coping strategies of a range of
people with long-term, serious chronic illnesses, the paper
argues that Government health policies and services in Australia
can best help people with chronic illness by supporting their
self-help groups and community-based activities. |
106 kb pdf |
|
People with Disabilities and Social Work: Historical and
Contemporary Issues |
From the
earliest recorded history, people with disabilities have been
ostracized, rejected, and discriminated against in society.
Although social work has a history rich in advocacy for
oppressed people, the profession has been hesitant to become
involved with people with disabilities. This article addresses
historical and contemporary issues concerning disability. Recent
developments in the disability movement, including independent
living, are discussed and compared to social work's approaches
to disability |
|
|
Philadelphia Settles Lawsuit Over Alleged Discrimination Against
HIV-Positive Man by EMTs |
The city of
Philadelphia on Monday settled a civil-rights lawsuit over
alleged discrimination against an HIV-positive man who said that
city emergency medical technicians provided inappropriate care
after they leaned his HIV status |
|
|
Population Council: Annual Report 1999 |
An
International Group that seeks to improve the well-being and
reproductive health of current and future generations around the
world and to help achieve a humane, equitable, and sustainable
balance between people and resources |
1,969 kb pdf
|
|
Positively Abandoned: Stigma and Discrimination against
HIV-positive Mothers and their Children in Russia |
Russia is
home to one of the fastest-growing and potentially massive AIDS
epidemics in the world, but the government has done little to
address the problem. As a result, the Russian public today,
though highly educated, is almost as ignorant of HIV and how it
is spread as it was ten years ago, when AIDS was hardly known in
Russia |
Pdf 303 kb |
|
|
|
Prejudice from Thin Air: The effect of Emotion on Automatic
Intergroup Attitudes |
Two
experiments provide initial evidence that specific emotional
states are capable of creating automatic prejudice toward
outgroups. Specifically, we propose that anger should influence
automatic evaluations of outgroups because of its functional
relevance to intergroup conflict and competition, whereas other
negative emotions less relevant to intergroup relations should
not. |
162 kb pdf |
|
Ramatex on
Rack Again |
A petition
signed by nearly 700 employees cites poor wages, cramped living
conditions and health concerns as their most pressing
grievances. Their concerns peaked last week, when at least two
employees were forced to return to the Philippines after being
declared sick and unfit to work, assertions they dispute. |
|
|
Report of the National Conference on Human Rights and HIV/AIDS
|
HIV/AIDS
is not merely a medical problem: the manner in which the virus
is impacting upon society reveals the intricate way in which
social, economic, cultural, political and legal factors act
together to make certain sections of society more vulnerable.
The epidemic exposes the method and the impact of
marginalisation and inequality in clear terms. Marginalised
groups in our society have little or no access to basic
fundamental and Human Rights such as food, medical services and
information. Many of these groups are ostracised by society at
large, and their lifestyles criminalized, making it practically
impossible for them to participate in mainstream processes
whereby they could demand their rights. Coupled with this dismal
situation, there is minimal awareness about HIV and no real
options for safer lifestyles. The stark reality of the HIV/AIDS
epidemic is thus that people are becoming HIV positive because
they have no access to basic fundamental Human Rights.
|
|
|
Resource Manual for Support of Dentists with HBV, HIV, TB and
Other Infectious Diseases |
Infected
practitioners have various legal rights and responsibilities, as
do persons with whom they associate. There are civil rights laws
prohibiting discrimination against persons with disabilities,
which afford numerous protections to infected providers and
those who associate with them. These and other state laws (e.g.,
pertaining to confidentiality and practice restrictions) may
bear upon an infected provider's practice. |
|
|
Rethinking AIDS as Social Responsibility |
AIDS control
efforts reflect the best and the worst face of globalization.
How are the dual sides manifest in relation to AIDS and how can
we capitalize on the positive and counter the negative
implications? These are the central concerns while
conceptualizing the workshop |
|
|
|
"You have to
recognize which kinds of stigma and discrimination are harmful
for disease control," explains Dr. James W. Curran, an AIDS
epidemiologist and professor at Emory University in Atlanta. "It
depends on the country; it depends on the laws, the values, the
particular subculture. The issues have to be identified and then
they have to be combated. It's like weeds in a garden; you have
to keep pulling." Around the world, reactions to the AIDS
epidemic have ranged from silence and denial to hostility and
outright violence. Fear of being branded or socially outcast may
prevent a person from being tested for the virus or from seeking
treatment if he or she has HIV. People who have or are thought
to have the virus may be shunned, abused, denied jobs and
housing, or refused care and treatment at health care
facilities. These reactions hamper prevention and treatment
efforts and deepen the epidemic's impact. |
|
|
Single-Motive and Multi-Motive Processing of a Threat Appeal:
Promoting the Preventative Health Behavior of Influenza
Vaccinations |
This study
considers the impact of behavioral commitment on the cognitive
and affective processing of a persuasive message advocating
influenza vaccination behaviors, and the resulting impact on the
integration of information into attitudes, behavioral intention,
and behavior. |
|
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Shaking off
'shame' |
In a
civilized society, people should not be scared to talk about
their ailments -- especially when the illness may have been
contracted from medical product infected with a potentially
fatal virus. Yet in Japan, between 1980 and 2001, an estimated
10,000 people may have been infected with the hepatitis C virus
(HCV) after being injected with a tainted blood coagulant during
labor or surgery -- but most choose to keep their condition
secret. |
|
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Silence about
AIDS is death |
We must
keep AIDS at the top of our political and practical agenda. That
is why we must continue to speak up openly about AIDS. No
progress will be achieved by being timid, refusing to face
unpleasant facts, or prejudging our fellow human beings -- still
less by stigmatising people living with HIV/AIDS. Let no one
imagine that we can protect ourselves by building barriers
between ‘us’ and ‘them’. In the ruthless world of AIDS, there is
no us and them. And in that world, silence is death |
|
|
Skills Development for
Multicultural Rehabilitation Counseling:
A Quality Of Life Perspective |
This article
focuses on a discussion of specific strategies usable in
promoting the development of leadership capabilities in
individuals with disabilities from minority groups. This paper
states that rehabilitative success in counseling such persons
depends on "the counselors understanding the life factors unique
to consumers whose sociocultural experiences are different."
|
|
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Social Stigma-A comparative qualitative study of integrated and
vertical care approaches to leprosy |
Leprosy has been
associated with stigma and social exclusion throughout history and
on all continents, although there are wide variations in the ways in
which this is worked out in different communities. Stigma can be
defined as an attribute that is deeply discrediting, and the
stigmatized individual is one who is not accepted and is not
accorded the respect and regard of his peers; one who is
disqualified from social acceptance |
Pdf 78 kb |
|
Stigma, Race, and Disease in 20th Century America: An Historical
Overview |
The topic of the
history of stigma, race, and disease is, of course, an expansive one
– even if one confines the discussion to the 20th century
United States. In my own field of the history and sociology of
medicine, the starting point for any such discussion of stigma must
be Erving Goffman’s classic 1963 book, Stigma: Notes on the
Management of Spoiled Identity |
|
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Stigma and
Discrimination |
Stigma is as old as history. While the word dates back to ancient
Greek times and refers to the physical mark made by fire or with
knives on individuals or groups considered outsiders or inferiors,
the concept appears universal. In different cultures and at
different times, slaves, criminals and adulterers – or those
suspected of being slaves, criminals and adulterers – have been
branded or otherwise physically marked. |
|
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Stigma and Acceptance of Persons with Disabilities |
We explore
this critical aspect of the social context by investigating
employee acceptance of a coworker who has a disability. We
conceptualize acceptance specifically in terms of an incumbent
employee’s attitude toward a coworker who has a disability,
perceptions, of fairness of accommodations the coworker
receives, and employment judgments about that coworker (with
respect to hiring, promoting, and retaining. |
144 kb pdf |
|
Stigma and Discrimination Defined |
[Erving] Goffman defined stigma as an "attribute that is deeply
discrediting" that reduces the bearer "from a whole and usual
person to a tainted, discounted one." Since Goffman, alternative
definitions have varied considerably. Two reasons for this
variation are that the concept has been applied to an enormous
array of different circumstances -- from schizophrenia to exotic
dancing -- and that it has been studied from the perspective of
many disciplines. We attempt to advance the study of stigma by
proposing a definition that encompasses these differences and
that attends to important critiques noting that much theory
about stigma is uninformed by the lived experience of the people
being studied and that research on stigma has an individualistic
focus, viewing stigmas as something in the person rather than a
designation that others affix to the person. |
|
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Stigma and Global Health: Developing a Research Agenda
|
"Typically,
miners who are believed to be infected are shunned. They sit
alone in buses that carry workers to the pit. They eat alone in
the company kitchens because their colleagues are afraid to
share utensils or crockery with them." |
|
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Stigma and Social Control
|
Social
interactions provide a set of incentives for regulating
individual behavior. Chief among these is stigma, the
status loss and discrimination that results from the display of
stigmatized attributes or behaviors. The stigmatization of
behavior is the enforcement mechanism behind social norms. This
paper models the incentive effects of stigmatization in the
context of undertaking criminal acts. Stigma is a flow cost of
uncertain duration which varies negatively with the number of
stigmatized individuals. Criminal opportunities arrive randomly
and an equilibrium model describes the conditions under which
each individual chooses the behavior that, if detected, is
stigmatized. The comparative static analysis of stigma costs
differs from that of conventional penalties. One surprising
result with important policy implications is that stigma costs
of long duration will lead to increased crime rates. |
Pdf 387 kb |
|
STIGMA AND VIOLENCE |
Stigma is
one of the most important problems encountered by individuals
with severe psychiatric disorders. It lowers their self-esteem,
contributes to disrupted family relationships, and adversely
affects their ability to socialize, obtain housing, and become
employed (Wahl, 1999). In December 1999, the Surgeon General’s
Report on Mental Health called stigma "powerful and pervasive,"
and then-Secretary of Health and Human Services Donna Shalala
added: "Fear and stigma persist, resulting in lost opportunities
for individuals to seek treatment and improve or recover." |
|
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Stigma is Social Death |
While
respondents cited a variety of sources of stigma, most
frequently mentioned were the attitudes and practices of the
mental health system and its workforce. Following are attitudes,
beliefs and practices within the mental health system thought to
be stigmatizing. Issues relating to power and control were most
often mentioned. These included the practice of forced treatment
as well as threats of forced treatment or of no treatment.
People also cited lack of involvement in treatment planning or
other aspects of decision-making about their lives. In addition,
restrictions on the freedom to come and go; being "placed" in a
house or apartment, and other examples were given. The
experience of having lower status than staff within the mental
health system was commonly mentioned. Many examples were given,
including cues within the physical environment such as separate
staff-client bathrooms and eating areas, demeaning and
infantilizing interactions between staff and
consumers/survivors, differences in status embedded in program
policies, and discriminatory treatment in employment of people
with psychiatric disabilities as mental health workers. |
|
|
Stigma of Hepatitis C and Lack of Awareness Stops Americans From
Getting
Tested and Treated |
Americans'
misunderstanding of the potential dangers of hepatitis C is
causing many with risk factors to forgo testing and treatment,
according to a landmark survey commissioned by American
Gastroenterological Association the
|
|
|
Stigma, Contagion, Defect Issues in the Anthropology of Public
Health |
Much of this
research has been framed by his interests in questions of
micro-social processes within which the self is created and
maintained. Goffman applied the term (negative) stigma to any
condition, attribute, trait, or behavior that symbolically
marked off the bearer as “culturally unacceptable” or inferior,
with consequent feelings of shame, guilt and disgrace. |
|
|
|
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Stigma, Discrimination and the
Conspiracy of Silence |
Stigma and
discrimination fuel the HIV/AIDS epidemic by creating a culture
of secrecy, silence, ignorance, blame, shame and victimisation,
says the International Council of Nurses (ICN). "Stigma
prevents communities from addressing HIV/AIDS with the
appropriate health care services, legal and educational
strategies," declared ICN president Christine Hancock. "What
stops them is HIV prejudice. And all that will stop HIV
prejudice is speaking openly about the facts. It is past time
for governments, civil society leaders and religious
institutions to end the conspiracy of silence and shame
surrounding HIV/AIDS." |
|
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Stigma in our Schools and Communities |
Stigma is
fundamentally different from discrimination. Most people
understand what discrimination is, but many are not clear what
stigma means. Discrimination focuses attention on the producers
of rejection and exclusion—those who discriminate against others
for any number of reasons. Stigma directs attention to the
people who are the recipients of these behaviors. |
136 kb pdf |
|
Stigma Interventions and Research for International Health |
Stigma has
become an increasingly important priority for health policy and
research. The topic encompasses a broad set of interests and
specifies a field of study, however, that without critical
rethinking may be too broad to contribute as much as we expect
to health policy. The diversity of international health problems
and the complexity of their social and cultural settings make
questions of stigma even more challenging. Too little attention
has been paid to the concept of stigma, distinct from its
impact; careful consideration of the particular features of a
useful formulation to guide public health policy and action is
needed, especially with respect to the stigmatizing diseases of
low- and middle-income countries. As we critically review of the
topic, we begin by considering a few key points from the seminal
contribution of the sociologist Erving Goffman |
|
|
"Stigma is Social Death" |
People
described a number of sources of stigma. Major sources included
family, friends and intimates, the job market and co-workers,
neighbors, people at church and in school. They also described
the practices of the housing market, insurance companies and the
social security system as being stigmatizing… Issues relating to
power and control were most often mentioned. These included the
practice of forced treatment as well as threats of forced
treatment or of no treatment. People also cited lack of
involvement in treatment planning or other aspects of
decision-making about their lives. In addition, restrictions on
the freedom to come and go; being "placed" in a house or
apartment, and other examples were given. |
|
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Stigma and Religion: An
Inevitable Partnership? |
"Stigma almost killed me" related one delegate who had been
ostracized from her church because of her HIV status. Her statement
underlined the continuing damage of HIV-related stigma, and the role
of religious leaders in reducing discrimination
|
|
|
Stigma of Hepatitis C and Lack of Awareness Stops Americans From
Getting Tested and Treated |
Hepatitis C is a potentially life-threatening viral disease of
the liver transmitted through blood and blood products. Over
time, chronic infection can lead to cirrhosis, liver failure,
and liver cancer. The survey findings indicate the need for
increased awareness and education about hepatitis C, the most
common blood-borne disease in the US. While only about half of
the general public believes it is a public health threat, more
than 80 percent recognize HIV poses a serious threat. In
contrast, physicians and hepatitis C sufferers surveyed view HCV
as a threat on par with HIV. |
|
|
Stigma when there is no other option: “The poor even segregate
the patient because there is nothing they can do to help” |
Power Point
Presentation |
966 kb |
|
Stigmas, Myths and Tuberculosis
|
Stigmatising
Others is a basic human reaction when the person feels fearful
for their own health or social status. In my opinion the history
of Tuberculosis provides possibly the most complete basis for
tracing the many ramifications of stigmatization of individuals,
of women as a gender, of 'race' and classes of occupation.
|
|
|
Stigma Toolkit-AIDS stigma. |
Understanding and challenging HIV stigma—toolkit for action |
9,937 kb pdf |
|
Stigma, Threat, and Social Interactions |
The chapters
in this and many other volumes attest to the importance of
stigma as a construct in psychology, sociology, and related
disciplines. Not surprisingly, stigma enjoys a long history as
a central construct in social psychology investigated by both
psychological and sociological social psychologists. Many
theorists have explicitly or implicitly woven stigma into their
explanations of stereotyping, prejudice, social justice, and
social identity. Researchers have accumulated a wealth of
information regarding the impact of stigmatized others (or
“targets”) on affective and cognitive processes of perceivers
and a more modest but substantial amount of information
regarding the impact of a stigma on the bearer. Researchers
have also accumulated much knowledge on the social identity of
the stigmatized, the consequences of membership in stigmatized
groups, and coping with stigma |
|
|
Strategies for working on the theme "stigma"
|
although
there is widespread awareness of the extent and impact of
stigma, we believe that the phenomenon as it relates to AIDS is
still little understood. As a consequence, the responses to
stigma, by policymakers, non-governmental organisations, the
media and others are consequently ill thought out and
ineffective. Stigma continues to represent a considerable
obstacle to AIDS prevention and care efforts, even in regions
such as Southern Africa where the epidemic is most widespread
and one would have expected ubiquity to have led to tolerance
and understanding |
|
|
Striking Lack of Awareness
|
"People with
hepatitis C infection deserve the same tools as those with HIV
so that they can become experts about their virus," explains
Michael Marco in the introduction to TAG's latest analysis of
hepatitis C research and treatment. |
|
|
Summary of HIV Prevalence and Sexual Behavior Findings |
This study
compares levels and trends of behavioral indicators such as
abstinence and age of sexual debut among youth, faithfulness in
sexual relationships, multiple sexual partners, and condom use. |
288 kb pdf |
|
Table of AIDS Knowledge and Attitudes
|
Youth
Indicators 1996—used in many US schools |
|
|
The Components and Impact of Stigma Associated with EAP
Counseling |
The economic
and social impact of workers with HIV/AIDS on businesses has not
waned with the increased public complacency regarding the virus
that seems to have marked the 1990s. This article provides a
general overview of the important issues surrounding
HIV-infected persons in the workplace, and provides
recommendations for employee assistance professionals concerning
both training efforts and the provision of accommodations for
persons with HIV/AIDS |
17 kb pdf
|
|
THE EXPERIENCE
OF SPECIFIC POPULATIONS |
This section
of the Paper aims to describe stigma and discrimination as
experienced by specific populations affected by the HIV epidemic
in Canada. The differentiation of populations affected by
HIV/AIDS is a social and cultural construction. Such
differentiation may itself contribute to discrimination, as when
drug users or sex workers are vilified as "vectors of disease."
On the other hand, the failure to recognize and acknowledge
publicly the experiences of a particular population in the
course of the HIV/AIDS epidemic has also led to neglect and
avoidance of that population's needs, as gay men have found in
the "de-gaying" of AIDS |
|
|
The Hidden Epidemic: Confronting Sexually Transmitted Diseases
|
There is a
tendency to look on AIDS and HIV and other sexually transmitted
diseases as issues largely of the developing world, particularly
sub-Saharan Africa and Southern and South East Asia. However,
some rich industrialised countries, particularly the United
States, have an epidemic of sexually transmitted diseases (about
12 million new cases annually, of which 3 million occur in
teenagers), and no national coordinated control programme of
education and clinical services. |
|
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The Impact of Stigma on Service Access and Participation
|
A guideline
developed for the Behavioral Health Recovery Management project
|
132 kb pdf
|
|
THE MEANING AND CONSEQUENCES OF PERCEIVED DISCRIMINATION IN
DISADVANTAGED AND PRIVILEGED SOCIAL GROUPS |
The
subjective meaning and consequences of perceived discrimination
depends on the position of one's group in the social structure.
For members of disadvantaged groups, attributions to prejudice
are likely to be internal, stable, uncontrollable, and convey
widespread exclusion and devaluation of one’s group. For members
of privileged groups, the meaning of attributions to prejudice
is more localized. Because of such meaning differences,
attributions to prejudice are considerably more harmful for the
psychological well-being of members of disadvantaged groups than
they are for members of privileged groups. According to the
Rejection-Identification Model (Branscombe, Schmitt, & Harvey,
1999), members of disadvantaged groups cope with the pain of
attributions to prejudice by increasing identification with
their disadvantaged group. We conclude with an exploration of
the social contextual factors that can affect how the
disadvantaged cope, and a discussion of the challenges facing
future research on attributions to prejudice. |
|
|
The Most Vulnerable of the Epidemic—Orphans
|
One was a
baby girl found by an orphanage in the garbage. When they
realized she had HIV, they put her back in the garbage
|
|
|
The role of stigma in reasons for HIV disclosure and
non-disclosure to children |
Given that
approximately 80% of women with AIDS are within their
reproductive years uncertainty about the future can include
concern about who will take care of their children should they
become incapacitated or die This additional stress can directly
impact both the family and children, particularly when women
must ‘hide’ their illness to protect their children. Relatedly,
mothers with HIV infection may also face the realities of the
stigma associated with HIV. |
|
|
The Socio-economic Impact of HIV/AIDS on Children in a Low
Prevalence Context: the Case of Senegal |
Discusses the
socio-economic impacts of HIV/AIDS on children in Senegal as
well as the impacts of the response policies implemented by the
different actors |
92 kb pdf
|
|
The Social Epidemiology of Human Immunodeficiency Virus/Acquired
Immunodeficiency Syndrome |
Social
epidemiology is defined as the study of the distribution
of health outcomes and their social determinants. It
builds on the classic epidemiologic triangle of host,
agent, and environment to focus explicitly on the
role of social determinants in infectious disease
transmission and progression. These determinants are
the "features of and pathways by which societal conditions
affect health". Early studies of human
immunodeficiency virus (HIV)/acquired
immunodeficiency syndrome (AIDS) focused on
individual characteristics and behaviors in determining HIV
risk, an approach that Fee and Krieger refer to as
"biomedical individualism." Biomedical individualism
is the basis of risk factor epidemiology; by
contrast, the social epidemiology perspective
emphasizes social conditions as fundamental causes of disease.
Social epidemiologists examine how persons become
exposed to risk or protective factors and under what
social conditions individual risk factors are related
to disease. Social factors are thus the focus of
analysis and are not simply adjusted for as
potentially confounding factors or used as proxies for
unavailable individual-level data. Social factors are
indeed critical to understanding nonuniform
infectious disease patterns that emerge as a result
of the dependent nature of disease transmission or
the idea that an outcome in one person is dependent upon
outcomes and exposures in others |
|
|
The
tendency to stigmatise |
This time-honoured
propensity has probably served humankind and its
ancestors well in the service of species and related
personal survival. Such biological mechanisms as those
subserving immediate survival, the quest for food,
reproduction and related territorial needs are
presumably its foundation. Moreover, the crudity of
categorisation and labelling of related perceived
possible threats needs, constitutionally, to be safely
over-inclusive, before juggling the consequent
options of relating to, coming to dominate, fleeing
from or ignoring the source |
|
|
The third phase of HIV pandemic: Social consequences of HIV/AIDS
stigma & discrimination & future needs
|
An overview
of social responses to AIDS, characterized by high levels of
stigma, discrimination central to the global AIDS challenge, as
related to human dignity is described. Stigma is conceptualized
as a problem of ‘they’ and ‘us’, or interactions perspective.
Causes and consequences to enable the varied perspectives in
understanding this third epidemic of social impact of HIV/AIDS
are described. In the absence of an effective medical
intervention, the social factors like stigma and discrimination
attached to HIV/AIDS are a major obstacle in the curtailment of
the disease requiring urgent action. The different forms of
stigma associated with other diseases are compared. Ignorance
about the disease, fear of discrimination and consequent denial
for testing and treatment, contribute to spread of the disease.
The disease status adds to vulnerability especially in women.
The disease is often identified with groups like intravenous
drug users (IDUs), and homosexuals who face a double stigma as a
result of HIV. Research scenario on stigma associated with
HIV/AIDS is reviewed to understand the future needs. Initiatives
of ongoing intervention to reduce stigma exist globally.
Emerging issues in research priorities have been highlighted to
counter consequences of pandemic from social perspective of
human dignity and rights. |
Pdf 71 kb |
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Through the Looking
Glass |
One of the most difficult tasks of
writing up any study is finding a title that accurately reflects
the nature and major findings of the work. In this
epidemiological study, the task is even more difficult, because
this survey is so closely linked to the class action suit and
the issue of monetary compensation of Hepatitis C positive
transfusion recipients. All sides in this legal and economic
struggle have taken considerable interest in our study's
results, because so little is currently known about the health
and socio-economic conditions of transfusion recipients. |
pdf |
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US to investigate impact of stigma on health
|
The US is
planning an ambitious programme of research into the impact of
stigma on human health, led by part of the National Institutes
of Health in Bethesda, Maryland. |
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Violence and Public Health ; A case study of recent violence in
Gujarat' |
The
discussion was centred on the break in confidence or trust of
all institutions and that there is urgent need of rebuilding
partnerships to prevent societies from fighting and breaking
apart. |
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Which Came First: Social Prejudice or Fear of Disease?
|
"Survey of
Canadian dentists reveals that 16% would refuse to treat HIV+
patients," reads a story reported in the April issue of the
American Journal of Public Health.[1] The only
good news in the survey is that people with HIV infection are
better off than those known to be injecting drug users (35%
would refuse to treat them) or infected with hepatitis C (36%
would not treat). Access to care has been a core policy concern
in the HIV epidemic since the disease was first recognized
nearly 20 years ago. Early on, we were moved to impassioned
public advocacy by stories of dinner trays left undelivered
outside hospital rooms; dying patients surrounded by what looked
like lunar exploration teams in full protective gear; reports of
dozens of calls made to secure one appointment for dental care;
nursing homes saying "we can't manage care that complicated."
The pain of the disease was magnified by the pain of rejection,
not only on the part of an uninformed public but also by those
supposedly committed to the care of all those in need. |
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Work Injuries and Illnesses Occurring to Women
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Report on
work injuries and illnesses occurring to women |
43 kb pdf
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Leprosy was
a disease of unparalleled implications in first-century
Palestine. It was a horrible disease; it spread slowly until it
made the body ugly and robbed it of vitality. It was a dreaded
disease; it meant separation from social life and from contact
with all non-lepers. Leprosy was a deadly disease. Because it
was incurable and eventually fatal, it made its victims the
living dead. And leprosy was a “sinners’” disease—not in that it
was contracted through personal sin, but because it formed an
apt metaphor for the nature of sin. |
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