Complex vulnerability: findings on stigma, social exclusion and criminalisation of a national survey on adults living with HIV in Argentina (September-november 2006)

PECHENY MARIO; MANZELLI HERNÁN

México

Congreso; AIDS 2008 • XVII International AIDS Conference • 3-8 August 2008, Mexico City; 2008

International AIDS Society

not external determinants but constitutive of the HIV/AIDS epidemic. Vulnerability to HIV infection, morbidity and mortality is a complex phenomenon, related to social structure. Data from a national survey on PWHIV show to what extent and how these aspects are intertwined. Methods: In 2006, we conducted a national survey (n=841; multi-stage sample) with PWHIV and 49 qualitative interviews with PWHIV and members of local AIDS programs in each province, including the following aspects: sociodemographic; employment and economic situation; sexuality, marital status and parenthood; illness history and current health status; treatments; and discrimination and social support. sample) with PWHIV and 49 qualitative interviews with PWHIV and members of local AIDS programs in each province, including the following aspects: sociodemographic; employment and economic situation; sexuality, marital status and parenthood; illness history and current health status; treatments; and discrimination and social support. In 2006, we conducted a national survey (n=841; multi-stage sample) with PWHIV and 49 qualitative interviews with PWHIV and members of local AIDS programs in each province, including the following aspects: sociodemographic; employment and economic situation; sexuality, marital status and parenthood; illness history and current health status; treatments; and discrimination and social support. Results: 13.9% of the sample had been in prison; 21.2% had injected drugs; 9.2% had experience of sex work (3% of heterosexual men, 9% of women, 12.1% of gays and 82.6% of transgenders); 33.3% had sex with an IDU (32% of heterosexual men, 42% of women, 22% of gays, bisexuals and transgenders); 20.4% had sex with a person who had been in prison (13% of heterosexual men, 30% of women, 19% of gays, bisexuals and transgenders); 22% of women had two and 4% three of these situations. Emotional vulnerability: 20% of heterosexual men, 25.3% of women, 21.1% of gays, bisexuals and transgenders had tried to commit suicide (66% after diagnosis). 33.2% reported fear of lacking of money to buy food, and 24.7% reported not having had enough money to buy food. Quantitative data show the interaction between stigma, discrimination, social exclusion and criminalisation, correlated to other indicators (e.g. morbidity or condom use). Qualitative data show alternative perceptions and strategies from PWHIV networks, health officials and practitioners. health officials and practitioners. 9.2% had experience of sex work (3% of heterosexual men, 9% of women, 12.1% of gays and 82.6% of transgenders); 33.3% had sex with an IDU (32% of heterosexual men, 42% of women, 22% of gays, bisexuals and transgenders); 20.4% had sex with a person who had been in prison (13% of heterosexual men, 30% of women, 19% of gays, bisexuals and transgenders); 22% of women had two and 4% three of these situations. Emotional vulnerability: 20% of heterosexual men, 25.3% of women, 21.1% of gays, bisexuals and transgenders had tried to commit suicide (66% after diagnosis). 33.2% reported fear of lacking of money to buy food, and 24.7% reported not having had enough money to buy food. Quantitative data show the interaction between stigma, discrimination, social exclusion and criminalisation, correlated to other indicators (e.g. morbidity or condom use). Qualitative data show alternative perceptions and strategies from PWHIV networks, health officials and practitioners. health officials and practitioners. 13.9% of the sample had been in prison; 21.2% had injected drugs; 9.2% had experience of sex work (3% of heterosexual men, 9% of women, 12.1% of gays and 82.6% of transgenders); 33.3% had sex with an IDU (32% of heterosexual men, 42% of women, 22% of gays, bisexuals and transgenders); 20.4% had sex with a person who had been in prison (13% of heterosexual men, 30% of women, 19% of gays, bisexuals and transgenders); 22% of women had two and 4% three of these situations. Emotional vulnerability: 20% of heterosexual men, 25.3% of women, 21.1% of gays, bisexuals and transgenders had tried to commit suicide (66% after diagnosis). 33.2% reported fear of lacking of money to buy food, and 24.7% reported not having had enough money to buy food. Quantitative data show the interaction between stigma, discrimination, social exclusion and criminalisation, correlated to other indicators (e.g. morbidity or condom use). Qualitative data show alternative perceptions and strategies from PWHIV networks, health officials and practitioners. health officials and practitioners. works, health officials and practitioners. Conclusions: This comprehensive study show a complex, structural context of vulnerability, related to poverty, gender, sexual orientation, drug use, sex work, and criminalisation. Stigma and discrimination are not attitudinal individual phenomena, but structural social processes. of vulnerability, related to poverty, gender, sexual orientation, drug use, sex work, and criminalisation. Stigma and discrimination are not attitudinal individual phenomena, but structural social processes. This comprehensive study show a complex, structural context of vulnerability, related to poverty, gender, sexual orientation, drug use, sex work, and criminalisation. Stigma and discrimination are not attitudinal individual phenomena, but structural social processes. Presenting author email: mpecheny@mail.retina.ar