Is There Divine Justice in AIDS? Why Now, and Not Before?

Cs, Bryan

doi:10.1097/00007611-199002000-00015

Cited by 5 publications

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“…Second, societies tend to attempt to blame the victims by identification of “folk devils” or scapegoats [10,13-18] with moral and sexual panic whipped up also by media [13-16,19,20]. There may also be an attempt to explain the collapse of morality with religious ideas that focus on God’s wrath, especially in deeply religious Hindu/Moslem societies as this one [20,21]. The enactment of this fear and blame leads to stigma and discrimination, and “blaming the victim” especially with respect to already stigmatized or sexually progressive groups (sex workers, men who have sex with men, women asserting financial and sexual independence, etc.)…”

Section: Introductionmentioning

confidence: 99%

Changes in HIV knowledge, and socio-cultural and sexual attitudes in South India from 2003-2009

et al. 2011

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BackgroundAs communities face serious pressures on traditional values, such as those posed by HIV infection, cultural inertia may result, whereby existing trends towards more liberalized views of sexuality are stalled. We examined changes in attitudes around HIV in Bagalkot district, south India, between 2003 and 2009.MethodsGeneral population surveys were conducted in 2003 and 2009, among approximately 6,600 randomly sampled men and women in 10 villages and 20 urban blocks of Bagalkot. Questions about HIV knowledge, sexuality, gender and condoms were included. We compared responses in the two surveys using a multivariate logistic regression model.ResultsAwareness of HIV increased significantly from 76.9% in 2003 to 87.8% in 2009, and condom awareness increased significantly (37.4% to 65.4%) in all groups studied. However, in 2009, only 23% of people mentioned condoms as a means of prevention, an improvement from 8% in 2003 (adjusted odds ratio (AOR) 3.3; 95%CI 2.6-4.1, p <0.001). There was a significant increase in the number of women believing sex workers should be compulsorily tested for HIV (76.3%-86.4%%, AOR 1.8; 95%CI 1.4-2.4, p<0.001). An increasing number agreed that “it is wrong to talk about sex” (p=0.05), especially women (21.9% vs. 32.4%, p<0.01). There was an increase in women who thought it “wrong to talk about AIDS in a respectable family”, and more respondents in 2009 thought it improper to discuss condoms (15.6% vs. 27.4%, AOR 1.9, 95%CI 1.4-2.8, p=0.001). In 2003, 31.4% agreed that “access to condoms promotes promiscuity”, increasing to 45.2% in 2009 (AOR 1.7; 95%CI 1.3-2.3, p<0.001). Educated and young urban women were the most likely to believe this. In 2003, 19.3% and in 2009 30.2% (AOR 1.8, 95%CI 1.4-2.3, p<0.001) thought that sex education promotes sexual activity and promiscuity.ConclusionsDespite increases over time in HIV-related knowledge and reductions in stigmatizing attitudes, resistance to changing cultural mores was apparent, with less willingness to embrace openness and discuss sexuality. Young and female respondents appeared to be the most resistant to change, reflecting a cultural inertia that mirrors studies of other pressures on traditional societal values. More effort is required to advocate among women and young people for healthy sexuality, openness and safe sex practices.

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Section: Introductionmentioning

confidence: 99%

Changes in HIV knowledge, and socio-cultural and sexual attitudes in South India from 2003-2009

et al. 2011

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Bryan¹

2002

Health Care Analysis

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Problems posed by HIV/AIDS differ from those of past epidemics by virtue of unique properties of the causative agent, dramatic societal changes of the late 20th century, and the transition of medical practice from a professional ethic to a technology-dependent business ethic. HIV/AIDS struck during the coming-of-age of molecular biology and also of bioethics, and the epidemic stimulated the growth of both disciplines. The number of articles published about AIDS and ethics (as identified by a MEDLINE search) peaked in 1990, just before the peak incidence of AIDS in the United States. The character of ethical dialogue has now shifted from familiar moral quandaries such as civil liberty versus public welfare to concerns about vaccine trials and public policy toward the developing world. Physicians and other health care workers who were involved from the onset endured something of an emotional roller coaster. Their compassion-based work ethic was to a large extent replaced by a competence-based work ethic after the introduction in 1996 of highly active antiretroviral therapy. The abundant recent literature on "professionalism" in medicine makes scant mention of AIDS/HIV. The disruptive effect of AIDS/HIV on society would have been substantially greater had relevant technology such as the ability to isolate retroviruses and potent therapy against tuberculosis not been in place. This sobering consideration, along with such recent events as the use of bioterrorism against civilian populations, suggests new relevance for Potter's definition of "bioethics" as a science of survival in which the biology of ecosystems must be taken into account.

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Charles Stone Bryan, MD: A Conversation with the Editor

Roberts

1999

Baylor University Medical Center Proceedings

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I) is one of the most interesting people I have met in several decades. He came to Baylor University Medical Center at the invitation of Dr. Marvin Stone and spoke at both the medical grand rounds and the medical housestaff conference in November 1998. I was introduced to Charley Bryan via his 1997 book. Osler: Inspirations from a Great Physician (Figure 2). This book cer-Figure 1. CSB photographed tainly brings Osler alive; I keep it by WCR in Montreal. 1999. on my bedside table and pick it up for short periods every week. When Marvin Stone invited me to attend the Osler Society meeting in Montreal in May 1999. I realized that that was an opportunity to meet and to interview Charles Bryan. Our conversation in Montreal follows. Additionally. his grand rounds lecture at Baylor. "Caring carefully: Sir William Osler on the issue of competence vs compassion in medicine." was recorded. and after some editing Dr. Bryan agreed to have it included in our publication as well. Dr. Bryan is a product of South Carolina. He was born and raised in Columbia and after public high school entered Harvard College. where he remained for 2 years before entering Johns Hopkins University and Johns Hopkins University School of Medicine. obtaining his medical degree in 1967. He interned in pathology at Hopkins and then went to Vanderbilt University in Nashville to intern in medicine. After 2 years in the Public Health Service in Galveston. Texas. he returned to Nashville and Vanderbilt for another year of internal medicine and then 2 years as a fellow in infectious disease. In 1974 he returned to Columbia in private practice and was the only infectious disease expert in Columbia for more than 15 years. In 1977 the University of South Carolina School of Medicine was created in Columbia. and Dr. Bryan became its first chief of the Division of Infectious Diseases and associate professor of medicine. In 1980 he became full professor. and in 1992 at age 50 he became chairman of the

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Is There Divine Justice in AIDS? Why Now, and Not Before?

Cited by 5 publications

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Changes in HIV knowledge, and socio-cultural and sexual attitudes in South India from 2003-2009

Changes in HIV knowledge, and socio-cultural and sexual attitudes in South India from 2003-2009

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Charles Stone Bryan, MD: A Conversation with the Editor

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