WWW.BOOK.DISLIB.INFO
FREE ELECTRONIC LIBRARY - Books, dissertations, abstract
 
<< HOME
CONTACTS



Pages:   || 2 | 3 | 4 | 5 |   ...   | 14 |

«Der Open-Access-Publikationsserver der ZBW – Leibniz-Informationszentrum Wirtschaft The Open Access Publication Server of the ZBW – Leibniz ...»

-- [ Page 1 ] --

econstor

www.econstor.eu

Der Open-Access-Publikationsserver der ZBW – Leibniz-Informationszentrum Wirtschaft

The Open Access Publication Server of the ZBW – Leibniz Information Centre for Economics

Luger, Lisa

Working Paper

HIV, AIDS prevention and class and socio-economic

related factors of risk of HIV infection

Veröffentlichungsreihe der Forschungsgruppe Public Health, Wissenschaftszentrum Berlin

für Sozialforschung (WZB), No. P98-204

Provided in cooperation with:

Wissenschaftszentrum Berlin für Sozialforschung (WZB) Suggested citation: Luger, Lisa (1998) : HIV, AIDS prevention and class and socio-economic related factors of risk of HIV infection, Veröffentlichungsreihe der Forschungsgruppe Public Health, Wissenschaftszentrum Berlin für Sozialforschung (WZB), No. P98-204, http:// hdl.handle.net/10419/47417

Nutzungsbedingungen: Terms of use:

Die ZBW räumt Ihnen als Nutzerin/Nutzer das unentgeltliche, The ZBW grants you, the user, the non-exclusive right to use räumlich unbeschränkte und zeitlich auf die Dauer des Schutzrechts the selected work free of charge, territorially unrestricted and beschränkte einfache Recht ein, das ausgewählte Werk im Rahmen within the time limit of the term of the property rights according der unter to the terms specified at → http://www.econstor.eu/dspace/Nutzungsbedingungen → http://www.econstor.eu/dspace/Nutzungsbedingungen nachzulesenden vollständigen Nutzungsbedingungen zu By the first use of the selected work the user agrees and vervielfältigen, mit denen die Nutzerin/der Nutzer sich durch die declares to comply with these terms of use.

erste Nutzung einverstanden erklärt.

zbw Leibniz-Informationszentrum Wirtschaft Leibniz Information Centre for Economics Veröffentlichungsreihe der Arbeitsgruppe Public Health Wissenschaftszentrum Berlin für Sozialforschung ISSN-0948-048X P98-204 HIV/AIDS prevention and ‘class’ and socio-economic related factors of risk of HIV infection von Lisa Luger* mit einem Vorwort von Rolf Rosenbrock Berlin, April 1998 *Imperial College, London, U.K.

Publications series of the research unit Public Health Policy Wissenschaftszentrum Berlin für Sozialforschung D-10785 Berlin, Reichpietschufer 50 Tel.: 030/25491-577 Abstract Trotz einer Vielzahl präventiver Bemühungen ereignen sich nach wie vor HIV-Infektionen. Nachdem sich die Epidemie ursprünglich hauptsächlich unter schwulen Männern der Mittelschichten ausgebreitet hatte, erstreckt sie sich zunehmend auch auf Menschen aus unteren Sozialschichten. Infolge dessen tragen derzeit Menschen mit niedrigem Sozialstatus ein höheres Risiko im Hinblick auf die HIV-Infektion.

Zudem verfügen sie im Falle einer Infektion über geringere Möglichkeiten der Belastungs- bzw. der Krankheitsbewältigung.

Die Gruppe der schwulen Männer entwickelte von Beginn an kollektive Antworten auf die Bedrohung durch HIV und begrenzte auf diese Weise erfolgreich die Anzahl von HIV-Infektionen in ihren Reihen. Menschen mit niedrigem sozialen Status scheinen dabei von Präventionsbotschaften weniger erreicht zu werden, sei es weil diese Botschaften an ihnen vorbeigehen, sei es, weil die Botschaften für sie weniger verständlich übermittelt wurden oder sie es, weil diese nicht hinreichend auf den sozialen und kulturellen Kontext dieser Gruppen bezogen sind. Möglicherweise haben Präventionsprogramme sozio-ökonomische und schichtenspezifische Unterschiede sowie ihre Implikationen in Hinblick auf HIV/Aids nicht hinreichend berücksichtigt.

Der vorliegende Literaturbericht gibt einen Überblick über Befunde zu schichtspezifischen Unterschieden und Faktoren in ihrem Verhältnis zur HIV-Infektion. Es werden Gründe herausgearbeitet, die das erhöhte Risiko einer HIV-Infektion bei Menschen aus unteren Sozialschichten sowie den begrenzten Erfolg von Präventionskampagnen in diesen Bevölkerungsgruppen erklären können. Außerdem werden Interventionsstrategien vorgestellt, mit denen die sozial bedingten Unterschiede des Risikos einer HIV-Infektion überwunden werden könnten.

Der Bericht benennt Wissenlücken in Hinblick auf Faktoren, die die unterschiedliche Vulnerabilität unterschiedlicher Bevölkerungsgruppen im Hinblick auf die HIV-Infektion erklären können. Benötigt werden mehr sorgfältig begleitete und evaluierte Interventionen, die auf die Verbesserung von Lebens- und Arbeitsbedingungen benachteiligter Gruppen abzielen, um ihre Vulnerabilität gegenüber Erkrankungen allgemein und speziell der HIV-Infektionen senken. Gleichzeitig sollten beim Entwurf und der Weiterentwicklung von Präventionsbotschaften der Wissensstand und die Lebensbedingungen von Menschen in unteren Sozialschichten stärker berücksichtigt werden. Auch fehlt es an Wissen über Zusammenhänge zwischen sozio-ökonomischem Status einerseits sowie der Lebensqualität und Lebenserwartung nach einer HIV-Infektion andererseits. Einstellungen zum HIV-Antikörpertest, Zugang und Qualität der Krankenversorgung könnten im erheblichen Umfang durch sozioökonomische Unterschiede beeinflußt sein. Dies beleuchtet noch einmal die besondere Bedeutung verbesserter Primär-Prävention für untere Sozialschichten.

Danksagung

Ich bedanke mich bei all jenen, insbesondere bei Angela Burnett, Reinhold Gruen, Rainer Herrn, Rolf Rosenbrock und Ben Webb, die mich durch wertvolle Hinweise zur Gliederung, zum Inhalt und zur Begrifflichkeit früherer Fassungen dieses Papiers unterstützt haben.





Abstract Despite a multitude of prevention activities people continue to be infected by HIV.

The epidemic which initially emerged among middle class gay men seems to have shifted toward working class people. Subsequently, people with lower socioeconomic background seem to be more at risk of HIV infection and to have fewer possibilities to cope with the risk of HIV infection.

The gay community quickly developed a collective response to the threat of HIV and successfully limited the infection with HIV among its members. People with lower socio-economic background seem to have been reached less by prevention messages, either because these messages might not have been accessible to them or they have not been well understood or not related to the social and cultural context of these population groups. Prevention programmes might not have taken into account possible class and socio-economic differences and their implications on HIV/AIDS.

This literature review provides an overview on what is known about class and socioeconomic factors and their influence on HIV infection. It explores reasons why prevention intervention have had limited success and identifies factors which increase the risk of HIV infection. It also presents intervention strategies to overcome social inequalities in relation to HIV infection.

The report concludes that more information is needed on the factors which make people vulnerable to infection with HIV. More evidence-based interventions need to be developed and implemented to improve the living and working conditions of disadvantaged people in order to decrease their vulnerability to HIV infection and illness in general. At the same time, prevention messages need to be designed and adapted to the knowledge level and culture of people in working class settings.

It is further recommended to look more in detail at the effect of socio-economic status in quality of life and life expectancy once a person is infected with HIV. Attitudes towards testing, access to health care and quality of health care may be strongly influenced by socio-economic differences, which highlights the importance of improved prevention interventions.

Acknowledgement Thanks to all the people who supported me in this work, especially Angela Burnett, Reinhold Gruen, Rainer Herrn, Rolf Rosenbrock, and Ben Webb for their valuable comments on structure, content and wording of earlier drafts of this report.

Contents

0. Preface by Rolf Rosenbrock

1. Introduction

1.2 Aims

1.3 Methodology

1.4 Structure

2. Background

2.1 Dimension of the HIV/AIDS Epidemic World-wide

2.2 Focus on EU Countries

2.3 Ongoing HIV/AIDS Infection Despite Extensive Prevention Activities.............. 4

3. Definition of ‘class’ and social inequality

3.1 Definition of ‘class’

3.2 Problems with the ‘class’ model in the context of HIV

3.3 Socio-economic related inequalities in health

4. HIV/AIDS and ‘class’ and socio-economic factors of risk of HIV infection

4.1 What is known about socio-economic differences among people with HIV and AIDS?

4.1.1 Social inequality and HIV/AIDS globally

4.1.2 HIV and income related inequality: the poor are more likely to be infected

4.1.3 Educational level and HIV-prevalence

4.1.4 Ethnicity as risk marker

4.1.5 Women and socio-economic differences in HIV infection

4.1.6 Injecting drug users and socio-economic differences in HIV infection

4.1.7 Gay men and socio-economic differences in HIV infection

4.1.8 Excursus: Socio-economic status and shorter survival

5. Factors which explain the different effectiveness of prevention intervention

5.1 Sexual Identity

5.2 Self-confidence

5.3 Emotional issue

5.4 Ability to communicate

5.5 The social status of women

5.6 Social Networks

5.7 Social issues of prevention receptivity

5.8 Cognitive issues

5.9 Social issues of risk perception

5.10 Specific vulnerability

5.11 Unspecific vulnerability

6. Intervention strategies to overcome social inequalities in relation to HIV infection

6.1 Sexual Identity

6.2 Empowerment

6.3 Social Networks

6.4 Social Issues of information distribution

6.5 Cognitive Issues

6.6 Specific Vulnerability

6.7 Unspecific vulnerability

7. Conclusions

8. Literature

0. Preface by Rolf Rosenbrock When public and political attention began to home in on the Aids epidemic in the early to mid-eighties and the paths of HIV transmission appeared, for the most part, to have been cleared up, the important thing was to decide what model should be used to organize the prevention of HIV infections. There are, in principle, two alternative possibilities. The “classical strategy for handling epidemics” based on the “old public health” paradigm (also called the search strategy or control and containment approach) looks for answers to the main question: how do we determine all the sources of infection as fast as possible, and how do we close them down? It contrasts with the relatively new health-sciences approach based on the logic of “new public health” (also called the learning strategy or inclusion and cooperation approach) that is guided by the main question: how do we organize population-wide social learning processes in as fast and time-stable a way as possible, processes in which individuals, groups, institutions and the whole of society adjust to life with the virus with maximum minimization of risk while avoiding exclusion and discrimination?

Civil-rights arguments and considerations about the effectiveness of prevention were crucial to the decision that was reached in nearly every country of the world, programmatically at least, in favor of new public health, the learning strategy – after national debates that were conducted with different degrees of harshness and controversy. It necessitated the development and implementation of social innovation: self-organized systems of incentives aiming at a group-related establishment and strengthening of social norms conducive to risk-avoidance and solidarity were to be created and stabilized by constant public education about the risks and the ways to avoid them – with priority utilization of personal communication and consultation. In this model the importance of the medical system and of repressive tools designed for coercive use took a backseat to respect for and support of the target groups’ life styles and milieus. That is why in most countries organizations of the groups mainly affected were also given a prominent role in the conception and implementation of primary prevention.



Pages:   || 2 | 3 | 4 | 5 |   ...   | 14 |


Similar works:

«Leitsätze der Zentrale der KPD vom 19. Mai 1919 zum Versailler Friedensvertrag 1 Leitsätze über den Frieden I Die Friedensbedingungen der Entente gegenüber Deutschland sind die Bilanz der inneren und äußeren politischen und wirtschaftlichen Lage Deutschlands nach viereinhalb Jahren eines verlorenen imperialistischen Präventivkrieges und nach sieben Monaten der politischen Neubefestigung der imperialistischen Klassen durch eine Regierung der Scheinrevolution und der tatsächlichen...»

«Arti.cial States Alberto Alesina, William Easterly and Janina Matuszeski Harvard University, New York University and Harvard University February 2006 Revised: November 2008 Abstract We de.ne arti.cial states as those in which political borders do not coincide with a division of nationalities desired by the people on the ground. We propose and compute for most countries in the world two measures of the degree to which borders may be arti.cial. One measures how borders split ethnic groups into...»

«MSTC ADMINISTRATIVE POLICY Policy Section: ADMINISTRATION Policy Title: SEXUAL ASSAULT & SEXUAL MISCONDUCT NOTICE OF NON-DISCRIMINATION Mid-State Technical College (MSTC) does not discriminate on the basis of sex in its education programs and activities and is required by Title IX not to discriminate in such a manner. Questions regarding Title IX and this Policy may be referred to the College’s Title IX Coordinator or the Department of Education’s Office of Civil Rights. TITLE IX...»

«Comparative Study of Equating Methodology Versus Pre-Equated Panel Scoring Technical Report September 2007 Number W0701 Chuah Siang Chee American Institute of CPAs Copyright © 2007 by American Institute of Certified Public Accountants, Inc. Comparative Study of Equating Methodology versus Pre-Equated Panel Scoring 1 American Institute of CPAs Comparative Study of Equating Methodology Versus Pre-Equated Panel Scoring Introduction The purpose of this study was to determine whether linear...»

«International Journal of Intelligence and CounterIntelligence, 20: 50–64, 2007 Copyright # Taylor & Francis Group, LLC ISSN: 0885-0607 print=1521-0561 online DOI: 10.1080/08850600600888698 LISA A. KRAMER and RICHARDS J. HEUER JR. America’s Increased Vulnerability to Insider Espionage Because espionage is a secret activity, it is not possible to know how many spies are currently active in American organizations or exactly what the future will bring in terms of discovered espionage cases....»

«. Berufsund Wirtschaftspädagogik online Herausgeber von bwp@ : Karin Büchter, Martin Fischer, Franz Gramlinger, H.-Hugo Kremer und Tade Tramm Anja GEBHARDT (Pädagogische Hochschule St. Gallen) Die Charakteristika und Unterschiede wirtschaftswissenschaftlicher und wirtschaftspädagogischer Lernkulturen an Hochschulen aus Sicht der Studierenden Online unter: www.bwpat.de/ausgabe26/gebhardt_bwpat26.pdf seit 13.10.2014 in bwp@ Ausgabe Nr. 26 | Juni 2014 Berufliche Bildungsprozesse aus der...»

«2nd OECD CONFERENCE OF MINISTERS RESPONSIBLE FOR SMALL AND MEDIUM-SIZED ENTERPRISES (SMEs) PROMOTING ENTREPRENEURSHIP AND INNOVATIVE SMEs IN A GLOBAL ECONOMY: TOWARDS A MORE RESPONSIBLE AND INCLUSIVE GLOBALISATION Istanbul, Turkey 3-5 June 2004 WOMEN’S ENTREPRENEURSHIP: ISSUES AND POLICIES ORGANISATION FOR ECONOMIC CO-OPERATION AND DEVELOPMENT ORGANISATION FOR ECONOMIC CO-OPERATION AND DEVELOPMENT Pursuant to Article 1 of the Convention signed in Paris on 14th December 1960, and which came...»

«IP ASSETS MANAGEMENT SERIES IP Asset Development and Management: A Key Strategy for Economic Growth Cover images courtesy of: Scientific American; Molinos Nuevos (Museo Hidraulica), Murcia, Spain; www.waterhistory.org; Dr Monzur Ahmed; Schiöler at Experimentarium, Denmark.IP ASSETS MANAGEMENT SERIES 1 IP Asset Development and Management: A Key Strategy for Economic Growth PREFACE Intellectual Property (IP) in the form of patents, trademarks, copyrighted works, industrial designs, trade...»

«THE GERMAN RAILWAYS THE ECONOMIC AND POLITICAL FEASIBILITY OF FISCAL REFORMS DURING THE INFLATION OF * THE EARLY 1920S NORBERT PADDAGS FREE UNIVERSITY OF BERLIN * This paper is based on the author´s M.Sc. thesis, University of Oxford, 1995. I would like to thank Niall Ferguson, who acted as my supervisor, and Avner Offer for numerous suggestions and ongoing support. Hans-Joachim Voth not only gave helpful advice during the thesis project but also commented on an earlier version of this paper....»

«Adventuring Mastering Associating New Strategies For Teaching Children An way added a alright conventional and little cut of the business. A software trial is with the significant work includes expected each trust affiliate with job members that a recent 2005-2009 people. Much, you is this pdf perpetuity that is explaining the fundamentals during lazy company, via you save the entirely stainless phone deal. Considering procedures by their pace percent is else a real maintenance. Knowledge put...»





 
<<  HOME   |    CONTACTS
2016 www.book.dislib.info - Free e-library - Books, dissertations, abstract

Materials of this site are available for review, all rights belong to their respective owners.
If you do not agree with the fact that your material is placed on this site, please, email us, we will within 1-2 business days delete him.