Stigma and discrimination against people with HIV infection
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 knowl- edge base what is knownabout 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.
The traditional nuclear family is not the only option for fulfilling the modalities of love associated with it. Given the diverse modalities of conjugal, sexual, emotional and family bonds, few actual families have formed in ways com- patible with traditional ideas and expectations. Thus, children grow up being educated along whatever possible lines their histories have been written. Withor without HIV,asingle domicile in Brazil today often brings together more than the nuclearfamily:children fromdifferentmarriages live together as siblings; in the poorer classes, children circulate between adults without formal adoption;11 houses are crowded together, and the structure of tenements and shared plots make children a common asset (or as some believe, a common liability). In most cases, a ‘‘proper education’’, ‘‘proper family’’, ‘‘proper parental love’’, at least in line with what is traditionally considered necessary to family life, have become an unlikely ideal. Whatever re-arrangements for the upbringing of children have come to define the actuality of family life, they are not the exclusive preserve of families with HIV-positive members, nor of other groups who are stigmatised as ‘‘anti-family’’ and to whom the opposite of true domestic, peaceful, respectful love is attributed.
ภาพดอกไม้และการเลือกปฏิบัติกับผู้ติดเชื้อเอชไอวี 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 knowl- edge base what is knownabout 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. ครอบครัวนิวเคลียร์แบบดั้งเดิมไม่ได้เป็นเพียงตัวเลือกสำหรับ modalities ของความรักที่เกี่ยวข้องกับการตอบสนอง ให้ modalities หลากหลายของพันธบัตร conjugal ทางเพศ อารมณ์ และครอบครัว ครอบครัวน้อยจริงมีรูปแบบใน patible com วิธีคิดแบบดั้งเดิมและความคาดหวัง ดังนั้น เด็กโตการศึกษาพร้อมสิ่งสุดบรรทัดประวัติของพวกเขามีการเขียน Withor ไม่ มีเอชไอวี asingle ตั้งถิ่นฐานในบราซิลวันนี้มักนำกันมากกว่า nuclearfamily:children fromdifferentmarriages อยู่กันเป็นพี่น้อง ในชั้นเรียนย่อม เด็กไหลเวียนระหว่างผู้ใหญ่ไม่ยอมรับอย่างเป็นทางการ 11 บ้านอยู่แออัดกัน และโครงสร้างของ tenements และผืนร่วมทำเด็กสินทรัพย์ทั่วไป (หรือบางคนเชื่อ ว่า ความรับผิดทั่วไป) ในกรณีส่วนใหญ่ ''การศึกษา '', ''เหมาะสมครอบครัว '', ''ถูกผู้ปกครองรัก '', น้อยในบรรทัดที่มีสิ่งซึ่งถือว่าจำเป็นกับชีวิตครอบครัว ได้กลายเป็น ไม่น่าเหมาะ จัดเตรียมสิ่งใหม่สำหรับ upbringing ที่เด็กได้มากำหนด actuality ของครอบครัว พวกเขาจะไม่รักษาพิเศษ ของครอบครัวที่มีสมาชิกเอชไอวีเป็นบวก หรือกลุ่มอื่น ๆ ที่มี stigmatised เป็น ''ป้องกันครอบครัว '' และที่ ตรงกันข้ามกับในประเทศ เงียบสงบ เคารพรักแท้เกิดจาก การ
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