Family responses to HIV/AIDS in Mexico.

This paper presents findings from a qualitative study of household and community responses to HIV/AIDS in Mexico. Fieldwork took place in two contrasting settings: (a) Ciudad Netzahualcóyotl, a socially marginalized urban community and (b) the homosexual community of Mexico City, a sexually marginalized social network. 113 in-depth interviews were conducted with people with HIV/AIDS, their relatives and members of their social networks. This paper describes findings from interviews conducted with family members of persons with AIDS. Four stages of response are identified and characterized within each community: (i) life before AIDS, (ii) life during the discovery of AIDS, (iii) living with a person with AIDS and (iv) surviving those who have died from AIDS. The social marginalization of both communities is central in explaining how families respond to the disease. In Ciudad Netzahualcoyotl, social support derives from a local culture of kinship. In the gay community, on the other hand, solidarity arises out of friendship. Between social support and discrimination, many more "ambivalent" behaviours (neither fully supportive nor discriminating) are displayed by family members and friends. Fear, pre-existing family conflicts and prejudice nurture these negative responses. Family responses and the processes to which they give rise, also differ depending on whether or not a male or female household member is affected. Policy recommendations are made concerning how best to promote positive family and household responses to persons with HIV/AIDS and how to inhibit negative ones.

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

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.

PIP: Characterization of AIDS-related illness trajectories is essential to the design of programs intended to provide support and assistance to HIV-infected persons. These trajectories were investigated through in-depth interviews conducted with 113 HIV-positive persons or their family members from two contrasting communities in Mexico: Ciudad Netza (economically marginalized) and the gay community in Mexico City (sexually stigmatized). This trajectory consisted of 4 basic stages in both settings: 1) life before HIV infection, 2) the discovery of one's HIV seropositivity, 3) living as an HIV-positive person, and 4) facing death. In Ciudad Netza, the daily experience of poverty is so pressing that an HIV diagnosis tends to be viewed as yet another problem to be faced. For many Mexico City gays, HIV infection initiates the need to "come out" both as a homosexual and as an HIV-positive person. In each community, the HIV diagnosis was accompanied by much self-blame and self-recrimination. After diagnosis, many HIV-infected persons who had been living independently stopped working and returned home to live with their families--a step associated with both financial and psychosocial adjustment difficulties. As death approached, financial and health care needs intensified and social stigmatization added to the pain experienced by AIDS patients and their families. Among the needs identified through these interviews are legislation to combat discriminatory employment policies, more sensitive counseling and psychological support at the time of HIV diagnosis, referrals for those who lack family support, and courses for health workers to combat the rejection of patients with AIDS.

Research notes on social order and subjectivity: individuals' experience of susto and fallen fontanelle in a rural community in central Mexico.

Disciplines such as sociology and anthropology have showed that the experience of illness, is above all, a social product, that is, that social factors of different kinds play a central role in shaping individuals' subjectivity. This paper refers to the case of Ocuituco, a rural town of central Mexico. The article presents some of the results achieved through an interpretive sociological study of individuals' subjective experience of traditional illnesses such as susto, soul-loss, and fallen fontanelle. The aim is to analyze how Ocuituco's inhabitants attach meaning to, interpret, and experience these illnesses. The main point being made is that the subjective experience of traditional illnesses is shaped both by the cultural background of individuals, and by the sociological features of the setting where these individuals live. Data are interpreted in connection both to structural factors (poverty, medicalization, and patriarchy), and to the main traits that characterize individuals' view of their world: a sense of uncertainty, a sense of the unexpected as being normal, a sense of being oppressed, a familiarity with a patriarchal order. It is shown that both susto and fallen fontanelle are belief systems which allow individuals to interpret their circumstances and attach meaning to their problematic everyday life.

[Management strategies in HIV/AIDS at the family level]. / Estrategias de manejo en torno al VIH/SIDA a nivel familiar.

OBJECTIVE: To identify the critical points of the trajectories of the families of persons with AIDS which may serve as a basis to develop educational and support programs. THEORY AND METHODS: A qualitative investigation was conducted in 1995 in Ciudad Netzahualcóyotl, State of Mexico, Mexico. Rapid Assessment Procedures (RAP) were applied to determine the social, economic, demographic and cultural context of persons with HIV/AIDS in the community. Forty-six in-depth interviews were applied to persons with AIDS, their families and people from their social networks. RESULTS: The main aspects of the family response to the HIV/ AIDS are characterized, and it is demonstrated that it is possible to identify critical points in such a response which can be targeted through specific interventions. In Ciudad Netzahualcóyotl, a context of poverty, a migrating tradition, and gender social relations are the basis of the acceptance or rejection of persons with AIDS. The main finding refers to the ambiguos attitude, ranging from rejection to support, displayed by family members of persons with AIDS. This pattern varies according to the history and specific conditions of each family. CONCLUSIONS: Specific health interventions are proposed to support families with one or more persons with AIDS.