Bond VA, Chilikwela L, Kafuma T, Nyblade L; International Conference on AIDS (15th : 2004 : Bangkok, Thailand).
Int Conf AIDS. 2004 Jul 11-16; 15: abstract no. TuPeD5280.
London School of Hygiene and Tropical Medicine and University of Zambia, Lusaka, Zambia
Background: In 2002, as part of a multi-country country study on HIV/AIDS stigma, qualitative research was conducted in poor communities in 2 high-density urban Lusaka compounds and a rural Chieftaincy in Southern Province. Methods: Participatory rapid appraisal activities (free-listing, picture discussions and timelines), 68 key-informant interviews, 25 focus group discussions, 8 participatory workshops with children and in-depth interviews with 13 TB affected urban households were carried out. Structured text analysis using N4 software was conducted. Findings: The majority of the study population live in absolute poverty. It is very difficult to manage sick PHA and orphans in the context of absolute poverty and seasonal hunger, especially over a prolonged period. Poor households make painful decisions about the allocation of resources, including the reduction or withdrawal of food, treatment or space from PHA and orphans. These decisions are then experienced as stigmatising. This type of stigma tends to intensify over time and underlying judgements - leading to blaming the patient - are used to justify the stigmatising actions; poor women and children are especially subjected to this blame. In a sense then, a significant proportion of discriminatory actions are caused by the fact that HIV and AIDS is so difficult to manage in the context of poverty. This is evident in our material where one reason for less stigma in the urban site was special services (for example HBC, special HIV clinic, hospice) that people could turn to, when households and individuals could no longer cope. In the rural site, some of these services were completely absent and stigma related to household fatigue more pronounced. Conclusions: Since spiralling poverty is accompanied by spiralling stigma, any services or interventions that check poverty, will reduce stigma by actively enhancing the capacity of households and communities to manage the special needs of PHA.
Publication Types:
Keywords:
- Acquired Immunodeficiency Syndrome
- Child
- Demography
- Family Characteristics
- Female
- Foster Home Care
- Fractures, Bone
- HIV Infections
- HIV Seropositivity
- Humans
- Population
- Poverty
- Research
- Residence Characteristics
- Rural Population
- Zambia
- education
- therapy
Other ID:
UI: 102283085
From Meeting Abstracts