Controlling the AIDS epidemic calls for a radical shift in attitudes towards AIDS,which are marked by the stigmatisation of people who are HIV- positive. This task will be all but impossible unless normative definitions of gender relations between the sexes and what constitutes ‘‘family’’ are seriously rethought.These issues have seldom been part of the discussion on citizenship and rights in Brazil, though they have been discussed widely in the social sciences.9 Yet how many health workers,or formal and informal HIV/AIDS educators, have incorporated into their knowledge base what is known about the historical and cultural construction of definitions of the family, or question the determination of what is proper behaviour for men and for women? Both in AIDS education and prevention and in the organisation of health care for those with HIV/AIDS, reproduction and childcare continue to be thought of as women’s affair (or problem), something arising from the nature of being feminine, while men are rarely perceived or addressed as (future) fathers. As a result of this mentality, clinicians specialising in AIDS care, including in the AIDS referral centres where our studies are carried out, are stunned and do not know how to respond when men living with HIV say they want to start a family.
Stigma and discrimination are social responses to AIDS that can only be understood in terms of the broader relations of power and domination in society, which reflect and reproduce inequalities of class, gender, age, race, ethnicity, sexuality and sexual orientation. The symbolic violence which existing stigma and discrimination represent are interweaved with responses to HIV, intensified by association with notions of contagiousness and the fear of AIDS as inevitably fatal.9 The continuous association of HIV with sexual promiscuity, family disorganisation and drug use, all dimensions of life that are associated with ‘‘incurable deviancy’’, helps to explain why so many challenges remain in organising care for people living with HIV.
The literature on the Brazilian family describes the deconstruction of a single normative model (the traditional nuclear family) for procreating and raising children. Demographic studies have consistently shown that conjugal and family organisation, including the formation of the extended family, vary widely in Brazil, despite the clear hegemony of Christian beliefs among most Brazilians-and among the men living with HIV who were interviewed in this study.
.