August 05, 2008
Final thoughts
As I was walking down the street this morning, my last in Thailand, I saw a baby elephant just strolling along… Only in Bangkok…
Before I offer some finals thoughts about my research, a quick little story:
I held a focus group with about ten HIV-positive women the other day. It was outside in a courtyard, about 95 degrees and I was flushed as usual. After introducing myself and my work to the group, I asked them if they had any questions for me before we began. One of the women reached out to me and cupped my face with her hands and said, in Thai, "You look lovely." The other ladies started giggling, as did I, and of course, I got even redder… In any case, in light of the research I’m doing, this was such a poignant little moment, and here’s why --
This woman deals with family and friends who are afraid of her germs on a daily basis. Despite the laws in place to protect them, people living with HIV, especially women, face an endless amount of discrimination, implicit and explicit, in the workplace and at home, constantly. Yet she felt comfortable enough to reach out to me... She knew that I wasn't afraid of her. I could be completely misinterpreting cultural cues here that I don't fully understand. Still, there is something intensely powerful about simply reaching out and making contact with someone.
When I arrived here, I thought that I would research the feminization of the HIV/AIDS epidemic. Then, I began looking into religious issues regarding HIV treatment, and then ethical considerations, and then legal questions related to human rights, etc. I think that part of the reason for this wavering, aside from my own indecisiveness, is because I began to realize how closely interconnected so many facets of the HIV/AIDS epidemic really are. The feminization of HIV/AIDS, gender inequality, the commercial sex industry, human rights, legal protections – none of these topics exist in isolation. At the same time, to tackle all in seven weeks would have been an impossible task.
In the end, I decided to take the information regarding ethical and practical problems with VCT and partner notification that I learned from interviews, and to analyze it from a women's rights perspective. Something that came up again and again in interviews was the heavy burden that women bear with respect to testing, partner notification, etc. Pregnant women are almost always tested for HIV (often without their official consent), and although many of them who test positive were actually infected by their husbands within the context of the marriage, they are the ones who carry the responsibility of informing their husbands of their positive status first in many cases. Also, female sex workers have been the focus of lots of testing and condom use campaigns. On the one hand, paying a lot of attention to women by way of testing and counseling of pregnant women and female sex workers is commendable. At the same time, it seems that the male population is harder to target, and their capacity and willingness to use protection or get tested is often underestimated or even ignored. To put it bluntly, from a health care perspective, it’s much easier to tell a pregnant woman what to do than her husband. Still, to act as if all men are unreceptive to any form of HIV education, testing, or prevention is to do them a disservice.
To address this, I decided to design a mass media social marketing campaign particularly targeted toward married men and discordant couples, in which one partner is positive and the other is negative -- a very difficult and largely neglected point of transmission that no interventions have been successful in targeting as of yet.
I’ll look forward to outlining my recommendations in more detail and sharing photos and stories during my presentation back on campus in a few weeks.
Cheers!
Sarah
Posted by Sarah Lane Schoenbrun at August 5, 2008 11:24 PM
