Vulnerability and Resilience in Living with HIV/AIDS

Abstract

This chapter emphasizes the impact on mental health when discrimination, stigmatization and xenophobia combine to humiliate the HIV positives. It analyzes their resilience and coping mechanisms in this situation. The main argument of the book will be supported by a number of case studies in this chapter. Countries where the HIV/AIDS epidemic is widespread, populations considered to be most-at-risk of contracting HIV/AIDS are generally the neglected groups from social, economic and epidemiological point of view. Consequently, very little effort is made to provide HIV interventions for these groups who, in turn, are often excluded from mainstream HIV prevention services. However, transmission rates and HIV prevalence among the high risk groups can be up to around 10 times higher than other groups in the society. This can be explained to a large extent by the growing level of discrimination, stigma and even hatred towards these groups, especially MSM. Mounting social and political rejection has magnified the notion that these groups are a class apart from the rest of society. The same pattern is reflected in public policy and legislation in the form of sodomy laws or the criminalization of homosexuality, and fuelled acts of violence against these groups in many countries. The level of isolation and vulnerability of refugees is multiplied if they become HIV positive. Automatically, they will suffer the stigma and rejection society reserves for other categories of most at risk populations from not only the society, but in their own households as well. Ultimately, as stigma and discrimination against them grow in society, the less access these populations have to HIV prevention and treatment and these groups as well as the rest of the society are more exposed and vulnerable.

Mainstreaming an approach to the measurement of vulnerability and resilience of this group affected by HIV/AIDS will allow us to track the impacts of their contexts on key domains of their functioning, surviving and thriving. The incorporation of the psychosocial indicators in the study of HIV/AIDS and refugee underscores the importance of psychological functioning and social inclusion as critical measures of the response of governments to the welfare of children affected by HIV/AIDS. There is a decline into worsening poverty with the loss of economic safety nets and adult wage earners, forcing many to withdraw from school and take up increased adult responsibilities for home care and work. Although families and communities remain the front-line of support for the infected, increasing strains on social networks and community resources due to the pandemic leave many of them abandoned and vulnerable to exploitation.