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The byline reflects the original authorship. The enormity and complexity of the stories and perspectives on the disease , which has affected so many millions of patients and families around the world , present significant challenges that demand continual reexamination.

The Persistence of Stigma Linked with HIV/AIDS in Health‐Care Contexts: A Chronic Social Incapacity

Questions of "what do we collect and from where" and "whose stories do we know best. Proposals will be considered in a variety of forms including paper presentations, panel discussions and posters. The program will be an afternoon session and evening reception the first day, followed by a full day of presentations the second. The Program Committee has identified the following themes to consider when developing your proposal, though we encourage creativity and experimentation in exploring themes, partnerships, and narrative ideas. The Program Committee welcomes proposals for individual papers, panel discussion and posters.

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Individual papers with a similar focus will be assembled into a single session by the program committee. Usually papers are included in a session. This history of the African AIDS epidemic is a much-needed, accessibly written historical account of the most serious epidemiological catastrophe of modern times. While Mbeki attributed the causes to poverty and exploitation, others have looked to distinctive sexual systems practiced in African cultures and communities.

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John Iliffe stresses historical sequence. He argues that Africa has had the worst epidemic because the disease was established in the general population before anyone knew the disease existed. HIV evolved with extraordinary speed and complexity, and because that evolution took place under the eyes of modern medical research scientists, Iliffe has been able to write a history of the virus itself that is probably unique among accounts of human epidemic diseases. In giving the African experience a historical shape, Iliffe has written one of the most important books of our time.

Permission to reprint Permission to photocopy or include in a course pack via Copyright Clearance Center. Click or tap on a subject heading to sign up to be notified when new related books come out. Although the male homosexual population was the first to be targeted as responsible for the disease during the s, researchers observed the presence of a persistent discourse, within the American public health context, attributing a measure of responsibility for the disease's transmission to prostitutes [ 50 ].

The discourse assumes that since there exist ways of avoiding infection, those who become infected are responsible i.

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Infection is thus equated with undesirable behaviors, particularly as regards sexual practices. We cannot demonstrate that beliefs determine actions, because both beliefs and actions are expressions of fundamental representations [ 72 ]. Researchers [ 73 ], for her part, provided a clear illustration of this assertion in her observations of exclusion rituals in homes where a family member suffered from mental illness, including the segregation of their clothing and linens from the rest of the family's laundry.


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  • This pessimistic AIDS archetype was increasingly contested during the early s by accounts that presented a divergent, more optimistic vision, culminating in the emergence of the archetype of the AIDS survivor. The third dominant archetype in the media in the early s was that of the HIV carrier. The public availability of antiretroviral drugs by made it possible for people infected with the virus to stave off the development of the syndrome.

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    The representations associated with this change centered on encouraging carriers to live their lives fully while keeping the virus under control through medicine. In contrast with the archetype of the survivor, the figure of the homosexual was not frequently portrayed as representative of the HIV carrier.

    The media did, however, associate the HIV carrier archetype with women portrayed as morally suspect, in particular prostitutes and women from disadvantaged backgrounds [ 50 , 76 ]. The three archetypal representations are linked with stigma, however. The victim of AIDS is represented as a victim also of discrimination and despair.

    The AIDS survivor is presented in a hopeful light.

    AIDS and Contemporary History

    With the exceptions noted above, the AIDS carrier, by contrast, is represented in a negative light, as having a body that is a source of risk and having permeable boundaries through which the HIV virus can be transmitted to others. It is worth noting that the emergence of the negative archetype of the HIV carrier coincided with the development of the first antiretroviral drugs, which gave rise to a new, positive dimension in the lives of the infected, but, having extended their life, gave rise also to fears of a greater risk that they might pass the virus on to others.

    The authors note, as well, that caregiver testimonies indicate that a similar positive change in attitudes toward patients has also permeated other areas of health care. The stigmatizing attitudes described above are founded in specific discourses and representations, and can range from an indifferent gesture to a convinced decision, from passive negligence to violent rejection.

    The distance between caregivers and patients has lessened over time, as evidenced by patient testimonies of positive experiences in interactions with health services. In the reviewed literature, the notion of stigmatization covers a wide range of psychosocial phenomena attitudes and behaviors of caregivers and perceptions those of both caregivers and patients that require a more comprehensive conceptual definition of stigma and the process of stigmatization than has been offered to date.

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    The perspective developed by Goffman, which focuses on interaction frameworks, provides solid footing on which to develop an understanding of the nature and manifestations of stigmatization in the specific context of health services.