Assessing the Social and Behavioral Science Base for HIV/AIDS Prevention and Intervention Workshop Summary (1995) / Chapter Skim
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PART II LEARNING FROM LIVES: INDIVIDUALS WITHIN A SOCIAL CONTEXT
PART II LEARNING FROM LIVES: INDIVIDUALS WITHIN A SOCIAL CONTEXT
Pages 11-20
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From page 11... ...
The discussion has been highly focused on individual responsibility, personal morality, and psychology. As researchers develop an increased understanding of the importance of social forces on individual practices, perhaps they will expand their focus and consider new options for more effective interventions that can take advantage of the critical junctures where social behavior generates individual risk.
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From page 12... ...
Understanding such phenomena on an operational basis and designing strategies that effectively reduce at least some of the multiple, and often overlapping, barriers these phenomena present to public health interventions is the goal of social and O ~ ye lavlora science. MARK'S STORY: A YOUNG GAY MALE IN SAN FRANCISCO HIV seroconversion rates in San Francisco are estimated to be 2.6 percent per year for gay men 18 to 29 years of age, with 28.9 percent of the men being seropositive by age 27 to 29.
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From page 13... ...
Mark has not been tested for HIV and feels he is not at risk, saying that "only older men have AIDS." He has not used condoms with the two partners that he considers boyfriends; he says that using condoms would imply that he didn'ttrust them. Mark reports that he occasionally feels uncertain about his sexual identity, feels alienated from the larger gay community in San Francisco, feels consistent pressure to use drugs, has trouble using condoms on a regular basis, and feels lonely and in need of a regular partner.
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From page 14... ...
I was so busy trying to make sure that he knew that I didn't blame him, that I really couldn't express all of what I was feeling to him. So I went in the bathroom when I came home, I remember I went in the bathroom, and I got on my knees, and I just cried, and I asked God, I said, I can't ask you to take this away because you allowed this to happen to me, but if you will, if you will, please, let this you know, I felt like Jesus Christ at the cross let this cup pass if it's your will." Janice's story of childhood victimization interfering with later decisionmaking about safer sex practices is similar to the stories of other women and men scarred by childhood abuse (Laumann, et al., 1994, Chapter 9~.
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From page 15... ...
His wife, who is now the partner of another military man, is much thinner than she was a year ago and she has had a case of herpes poster; two of her children are also HIV-positive. The soldier had at least two sexual partners in rural Haiti other than his wife and Acephie.
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From page 16... ...
COMMERCIAL SEX WORKERS IN THAILAND Recent studies of the mobility and migration of commercial sex workers in Thailand show that the women's choices are constrained by broad historical forces as well as by more local cultural directives. To summarize a complex account, Thailand is in the midst of a major demographic transition, in which the young must increasingly care for a growing aging population.
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From page 17... ...
Thus, both broad historical forces and more local cultural imperatives have funneled women from the north of Thailand and the border states into commercial sex work in Thai cities and towns. Northern Thai women, who have a command of Central Thai language, in addition to friendship networks throughout the country, are in a better position to find employment in higher-paying establishments, where they have somewhat more control over their daily lives, as well as a greater likelihood of marrying economically stable partners.
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From page 18... ...
The four stories illustrate ways in which social variables in all contexts dyadic, cultural, environmental, economic, end political can constrain choice regarding health-protective behavior at the individual level. The choices of Janice, the African American woman, were constrained by a combination of historical forces and social norms regarding her place in the community and her obligations to her husband, and the choices of Acephie and the Thai women were constrained by large-scale social and economic forces.
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From page 19... ...
At the policy level, the decision can be constrained by regulations concerning reporting of HIV antibody test results and the attendant risk of violations of confidentiality or the imposition of state-mandated quarantine. Further, as the four stories illustrate, the social and economic consequences of being tested for HIV antibodies can vary markedly by gender, age, and culture.
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From page 20... ...
20 HIV/AIDS PREVENTION AND INTERVENTION forces can be tested in local settings. This will require further elaboration of existing interdisciplinary frameworks of social analysis or the creation of new ones.
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