Dr Operario loeng

Social Context of HIV/AIDS Principles of risk and transmission, pathways to social actionDon OperarioUniversity of OxfordUnited Kingdom: 

Social Context of HIV/AIDS Principles of risk and transmission, pathways to social action Don Operario University of Oxford United Kingdom

Presentation Overview: 

Presentation Overview Global View of HIV/AIDS HIV Transmission Factors 9 Social and Policy Opportunities

Acknowledgments: 

Acknowledgments Jacqueline Papo, Dept of Public Health, Oxford University Steph Topp, Dept of Development Studies, Oxford University Kristen Underhill, Dept of Social Policy and Social Work, Oxford University Riina Raudne, NIHD, Estonia

Every Month a Tsunami: 

Every Month a Tsunami

Slide5: 

2004 Tsunami = 170,000 – 250,000 deaths HIV/AIDS = 258,000+ deaths / month Fifteen 747s = 7500 passengers (approx) HIV/AIDS = 8000+ deaths / day

Slide7: 

Sub-saharan Africa South / SE Asia Latin America North America E Europe / C Asia East Asia W / C Europe N Africa / M East Caribbean Oceania Distribution of HIV/AIDS, 2005

Slide8: 

Sub-saharan Africa South / SE Asia Latin America North America E Europe / C Asia East Asia W / C Europe N Africa / M East Caribbean Oceania New HIV Infections, 2005

No Single HIV/AIDS Epidemic: 

No Single HIV/AIDS Epidemic

Slide10: 

Generalized Epidemic All sectors vulnerable Non-Generalized Epidemic Socially oppressed and marginalized groups most vulneralbe

Slide11: 

Contributors to Non-Generalized Epidemics Discrimination Ethnic Tension Poverty Gender Inequality Homophobia

Non-Generalized Epidemics Can Become Generalized: 

Non-Generalized Epidemics Can Become Generalized

Fundamental Risk Factors: 

Fundamental Risk Factors

Slide14: 

At the Individual Level

At the Social Level: 

At the Social Level Culture Intimate Relationship Dynamics Gender Norms Social Oppression Domestic Violence Peer groups Norms toward Sex Norms toward drugs Cultural health practices Social support

At the Societal Level: 

At the Societal Level Poverty Policy Environment Gender Violence War Legal Structures Stigma Health Care Education Forced Migration Ghettoization Employment Violence

HIV/AIDS is a Social Policy and Structural Issue: 

HIV/AIDS is a Social Policy and Structural Issue

9 Pathways to Action: 

9 Pathways to Action Structural Pathways Address AIDS Stigma Train National Experts Mobilize Political Will Social Pathways Reduce Social Inequalities among Communities Involve Communities at Risk Individual Pathways Provide Health Care and Treatment to PLWHA Lower Barriers to HIV Testing Teach Young People about Sexual Health Prevent Drug Use, Treat Addiction

Address AIDS-Related Stigma: 

Address AIDS-Related Stigma Anti-Discrimination Legislation AIDS = Health Issue, NOT Moral Judgment

Train Expert Professionals: 

Train Expert Professionals Invest in education of Estonian scientists, physicians, health policymakers Educate and train future generations of Estonians

Reduce Social Inequalities: 

Reduce Social Inequalities Acknowledge and reduce ethnic tension and inequality Acknowledge and reduce other social stigmas within Estonian society Tailor social/health programs for specific communities

Involve Communities: 

Involve Communities Seek collaboration with vulnerable groups Support local community initiatives

Provide Health Care and Treatment to PLWHA : 

Provide Health Care and Treatment to PLWHA Prepare for scale-up provision of antiretroviral treatment

Lower Barriers to HIV Testing: 

Lower Barriers to HIV Testing Rapid HIV Testing Confidential, non-coercive testing initiatives

Teach Young People about Sexual Health: 

Teach Young People about Sexual Health Comprehensive school based curriculum Encourage families to talk about sexual health

Prevent Drug Use, Treat Addiction: 

Prevent Drug Use, Treat Addiction Harm minimization Syringe Exchange Treatment programs

Political Will:: 

Political Will: 1. Anti-discrimination legistlation 2. Investing in the education and training of Estonian AIDS specialists 3. Developing tailored approaches for specific groups such as the Russian community 4. Involving communities in policy design and program implementation 5. Committing to the provision of antiretroviral treatment 6. Improving the capacity for people to know their HIV status 7. Formulating a sexual health curriculum for schools 8. Taking a harm minimization approach to drug prevention and treatment

--Elie Wiesel: 

--Elie Wiesel “The age of hypocrisy has been succeeded by that of indifference, which is worse, for indifference corrupts and appeases: it kills the spirit before it kills the body. It has been stated before, it bears repeating: the opposite of love is not hate, but indifference.”