Marseille 2007
| Abstract #495 - The impact of AIDS related stigma and discrimination on AIDS orphans and their caretakers in So Paulo, Brazil. | ||||
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Session: 22.7: Stigma (Parallel) on Monday @ 16.30-18.30 in Auditorium/Overflow Chaired by Heather Worth, Osman Malik Authors: Presenting Author: Prof Vera Paiva - University of So Paulo, Brazil |
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| Additional Authors: | ||||
| Aim: Understanding how discrimination and human rights violations are produced has contributed to mitigating HIV/AIDS vulnerability. The abandonment AIDS orphans suffer after losing their parents is aggravated by the stigma and discrimination associated with AIDS. In 2006, a comprehensive study was conducted in So Paulo, Brazil, with qualitative and quantitative approaches to describe experiences of stigma and discrimination and rights violations (considering nutrition, access to health, education, family/institutionalization). | ||||
| Method / Issue: Questionnaire-based interviews were conducted with probabilistic sample at household level, with consenting adult caretakers and young orphans (15-24 years old). On the qualitative component, 14 young orphans (HIV+ and HIV-) answered to in-depth semi-structured interview to capture scenes of stigma and discrimination; linked to public HIV/AIDS clinics in three neighborhoods of So Paulo 12 health providers and 11 primary caretakers, 7 educational supervisors were also interviewed, and 2 focus groups with teachers were conducted. | ||||
| Results / Comments: Throughout all the interviews, few participants would quickly recall experiences of stigma and discrimination related to AIDS. On the other hand, secrecy about parents death caused by AIDS was actively pointed out as a mode of coping with AIDS related stigma; many children just do not know it because their primary care taker never told them; most of those who know, conceal this information at school or community. In the qualitative component, we also observed that: a) Losing ones mother is perceived as a stronger deficit than losing ones father. In general, women from the mothers family take responsibility for orphan care; b) Males appear as adequate caretakers of their children and siblings, yet are generally referred to as irresponsible and absent; c) Female orphans are perceived as fragile and needing protection; male orphans are described as independent, impulsive, and dangerous because they are considered more sexual, therefore they are more neglectable d) Sexuality is feared as promiscuous (as if inherited), or neglected as forming part of care; comprehensive information about sex to young people is often denied or poor, being them HIV negative or positive; e) The strongest scenes of stigma and discrimination are related to the sexuality of HIV positive young people or their parents; f) School professionals seem to expect that orphans performance and welfare depend on family structure (caretakers schooling, economic status, housing) and their parents life stories, often perceived as associated with drug use and improper sexuality. Educators believe that family fears prejudice, so seropositive and orphaned children are invisible; AIDS and orphanhood are secondary to major issues such as violence, unemployment, drug abuse and irresponsible sexuality. | ||||
| Discussion: Universal and free access to medication in Brazil make AIDS less visible; stigma and discrimination may decrease because people living with HIV might conceal their condition in daily life and as a result of access to treatment and other structural interventions aiming to mitigate it in Brazil. When it is reported in the orphanhood context AIDS related stigmas are linked to promiscuity and constructed by sexism - overburdening women and dismissing men as caretakers, overprotecting girls and abandoning boys, and restricting sexual rights. | ||||
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