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Social exclusion as a major HIV risk factor for the indigenous populations in Latin America: the need for a sustainable, multi-level solution
Background: Social exclusion is a major HIV risk factor for the indigenous in Latin America. The increase of indigenous HIV prevalence among the indigenous is noted in some studies, which needs to be analyzed from a multi-dimensional framework of social epidemiology. The goal of this study is to report the most recent results of indigenous HIV risks. The objective: to generate a sustainable framework of solutions.
Methods: This study combines a cross-national survey and meta-analysis of in-depth ethnographic interviews, focus groups, and case studies in Latin America. Eighty percent of the subjects interviewed were women. The analyses focus on: 1. globalization, and indigenous communities and ecosystems, 2. indigenous rights protection, 3. socioeconomic barriers, including access to the health system, 4. risk factors in gender relations, and 5. barriers in community capital building.
Results: Social exclusion is a major HIV risk factor for the indigenous through several pathways:
1. Globalization is related to environmental injustice, deepening of extreme poverty, and forced migration.
2. Inadequacy in indigenous rights protection leads to socioeconomic marginalization and discrimination.
3. Discrimination reduces access to culturally and linguistically appropriate care.
4. Marginalization causes the loss of indigenous ethno-medical knowledge.
These factors combined affect community capital building, a critical factor in HIV prevention and intervention. Decreasing community capital contributes to the loss of critical links and results in increasing gender violence, community disintegration, hazardous professional choices, and unhealthy life styles and practices, which increase HIV risks for the indigenous.
Conclusions: A large-scale cross-national survey and meta-analysis in Latin America demonstrate the urgency to address social exclusion in the prevention and intervention of HIV risks for the indigenous. An integrated framework needs to repair the critical links for the indigenous by combining top-stream, upstream, and downstream solutions in rights protection in the globalization context, improving tangible socioeconomic capital, and increasing intangible community capital.
AIDS 2008 – XVII International AIDS Conference
Abstract no. CDD0010
” M.L. Wang Social exclusion as a major HIV risk factor for the indigenous populations in Latin America: the need for a sustainable, multi-level solution. : AIDS 2008 – XVII International AIDS Conference: Abstract no. CDD0010″