Metodo suzuki

PII:

Soc. Sci. Med. Vol. 47, No. 10, pp. 1473±1484, 1998 # 1998 Elsevier Science Ltd. All rights reserved Printed in Great Britain S0277-9536(98)00193-2 0277-9536/98 $19.00 + 0.00

FAMILY RESPONSES TO HIV/AIDS IN MEXICO
ROBERTO CASTRO,1* EMANUEL OROZCO,2 PETER AGGLETON,3 Â ENRIQUE EROZA4 and JUAN JACOBO HERNANDEZ5
1 Centro Regional de Investigaciones Multidisciplinarias, Av. Universidads/n, Circuito 2, Col.  Chamilpa, Cuernavaca 62210, Mor., Mexico, 2Centro de Investigacion en Sistemas de Salud/Instituto Nacional de Salud Publica, Cuernavaca, Mexico, 3Thomas Coram Research Unit, Institute of  Education, University of London, London, U.K., 4El Colegio de la Frontera Sur, Villahermosa, Mexico and 5Colectivo Sol, Mexico City, Mexico

AbstractÐThis paper presents ®ndings from aqualitative study of household and community responses  to HIV/AIDS in Mexico. Fieldwork took place in two contrasting settings: (a) Ciudad Netzahualcoyotl, a socially marginalized urban community and (b) the homosexual community of Mexico City, a sexually marginalized social network. 113 in-depth interviews were conducted with people with HIV/AIDS, their relatives and members of their socialnetworks. This paper describes ®ndings from interviews conducted with family members of persons with AIDS. Four stages of response are identi®ed and characterized within each community: (i) life before AIDS, (ii) life during the discovery of AIDS, (iii) living with a person with AIDS and (iv) surviving those who have died from AIDS. The social marginalization of both communities is central inexplaining how families respond to the disease. In Ciudad Netzahualcoyotl, social support derives from a local culture of kinship. In the gay community, on the other hand, solidarity arises out of friendship. Between social support and discrimination, many more ``ambivalent'' behaviours (neither fully supportive nor discriminating) are displayed by family members and friends. Fear, pre-existing familycon¯icts and prejudice nurture these negative responses. Family responses and the processes to which they give rise, also di€er depending on whether or not a male or female household member is a€ected. Policy recommendations are made concerning how best to promote positive family and household responses to persons with HIV/AIDS and how to inhibit negative ones. # 1998 Elsevier Science Ltd. All rightsreserved. Key wordsÐAIDS, family, career, social support, solidarity, discrimination, prejudice

INTRODUCTION

A number of authors have highlighted the importance of social research in families where one or more members is a€ected by HIV and AIDS (e.g. Bonuck, 1993; Danzinger, 1994). This call derives both from the need to examine whether family and community care for people with HIV and AIDSis relatively cost e€ective (Ward and Brown, 1994) and from the importance of understanding the most immediate context, the family, in which for many people HIV-related illness evolves (Bor, 1990). In industrialising countries such as Mexico, it is of crucial importance to examine how ``community care'' for those a€ected by AIDS may vary according to factors such as social class, geographical zoneor ethnic group. Recent investigations also highlight the need to explore the limits to the family and community support received by people with HIV and AIDS (Seeley et al., 1993). Evidence from several countries has forced both a rede®nition of the concept of family (Levine, 1990) and a deeper exploration of the problems experienced by households in their e€orts to respond positively when one ormore
*Author for correspondence.

members is a€ected with HIV disease. A€ected households may face stigmatization (McGrath et al., 1993; Gilmore and Somerville, 1994) which can in turn a€ect their responses to AIDS (Powell and Brown, 1994). The families of people with HIV and AIDS may also undergo a process of adaptation about which little is currently understood (Barret and Victor, 1994)....