AIDS-related illness trajectories in Mexico: Findings from a qualitative study in two marginalized communities

Abstract

This paper describes findings from a recent study examining how people affected directly and indirectly by the HIV/AIDS epidemic cope with HIV-related illness in Mexico. One-hundred-and-thirteen in-depth interviews were conducted with key informants in two contrasting communities: Ciudad Netzahualcóyotl (an economically marginalized community) and the gay community in Mexico City (a sexually marginalized community). This paper describes the AIDS-related wellness/illness careers or trajectories followed by individuals in both communities, and identifies critical points for material and emotional intervention. This career comprises four stages: (1) life before infection; (2) life surrounding the discovery of seropositivity; (3) living as an HIV-positive person; and (4) facing death. Comparisons are drawn between the processes of adjustment and coping found in both communities. In Ciudad Netzahualcóyotl, wellness/illness careers are closely linked to prevailing poverty and oppression, as well as the sense of urgency in which local people live their lives. In the case of the gay community, wellness/illness careers are associated with the intolerance and social repression faced by homosexual men. The paper concludes by suggesting possible interventions to improve the lives of people with HIV/AIDS in Mexico today.

Self‐care and Subjectivity among Mexican Diabetes Patients in the United States

“…It is important to note, however, that our research design prevents us from knowing whether the emphasis on emotional and familistic forms of self-care among our participants is specific to Mexican culture. Although these forms of self-care are consistent with the way that traditional Mexican values have been characterized, as well as with well-documented Mexican ethnomedical models linking social, emotional, and physical health (Castro et al 1998;Finkler 1989;Rubel 1984), other patient populations may also embrace forms of self-care that privilege emotional and social well-being and diverge from dominant clinical models of individual responsibility (Baer 1996;Yates-Doerr 2012). There is evidence, for instance, that social class is a particularly important factor in shaping both ideologies of selfhood and health beliefs and behaviors (Kusserow 1999;Wardle and Steptoe 2003).…”

Stigma, HIV and health: a qualitative synthesis

“…People with HIV discussed being moralized within health care environments in a number of ways: being ignored or infantilized, drawing disparaging comments, receiving neglectful care or being denied care due to a perceived denigrated lifestyle. Some studies also noted the power dynamic of health care centers, where the social positioning and professional status of health care practitioners permitted them to dictate “what is best for the patient” [ 69 ]. As remarked in Rutledge et al (2009), this social positioning could contribute to providers using their societal power to engage in condemning practices while providing care at the same time [ 99 ]: “About two years ago I went to get a test for genital warts.…”

Sexual behavior and drug consumption among young adults in a shantytown in Lima, Peru

“…Therefore, it is necessary to control for alcohol consumption levels in order to establish the independent effect of illicit drug use on sexual behavior. Moreover, it is likely that varying cultural and environmental factors related to young adults' sexual practices (such as how acceptable it is for a young man to be initiated into sex by having sex with a sex worker or having casual partners) and drug use (such as the availability or popularity of different types of drugs) influence this association in different ways in different regions of the world [ 15 - 18 ].…”

“…They have found, for example, that 80% of young adults between 18 and 29 years of age in Peru have had intercourse, and that of this group, 30% of young men report having had intercourse with a sex worker [ 20 ]. However, few studies have focused on the sexual behavior of this population in shantytowns of Latin America [ 18 ]. Thus, information about attitudes and behaviors related to sexual health in this population is limited.…”