HIV and AIDS
Community reaction to older-age parental AIDS caregivers and their families: evidence from Cambodia
Concern more common than condemnation in attitutes to Cambodians living with HIV and AIDS
Authors:
J.E. Knodel; N. Williams; S.K. Kim; S. Puch; C. Saengtienchai
Publisher:
Population Studies Center, University of Michigan, 2009
Depictions of community reaction to persons with HIV/AIDS and their families often typically focus only on negative reactions, and have been based on assumptions and generalisations that are unduly influenced by anecdotal data and whose validity is largely undetermined.
This paper examines community reaction in Cambodia to families from the perspective of parents of adults who died of AIDS or persons with HIV/AIDS (PWHA). Survey evidence and open-ended interviews reveal a mixture of reactions related to social relations, interactions with local officials, gossip, business patronage, funeral participation, and orphaned grandchildren.
Although older age persons in Cambodia are much less likely to be infected with HIV than younger adults, they are very much involved with the epidemic through the illness and deaths of their HIV infected adult children. Many co-reside with their child at the terminal stage of AIDS, providing major care, and helping to pay medical expenses. They also often arrange and pay for the funeral. In addition, if young children are left behind, grandparents very commonly take responsibility for the orphaned grandchildren. Thus by fulfilling critical functions, older persons play an important role in helping mitigate the potential burden and adverse consequences that the epidemic poses for society. At the same time, being so intimately associated with the care and living arrangements of PWHA exposes older age parents to potential stigma and negative reactions by other community members.
Contrary to the common portrayals that emphasise negative aspects, the authors argue that not only that there is typically a mixture of positive and negative reactions present but that positive support from others in the community is often dominant and that negative reactions appear to be declining over time.
The research on the situation in Cambodia indicates that negative attitudes are decreasing as correct knowledge becomes more common amongst the general population. On a policy level, this underscores the important role that education can play (and has played in Cambodia) in reducing stigma and discrimination.
The authors conclude that they find little evidence that moral condemnation of the behaviors that may have contributed to HIV infection or that blame of the persons with HIV/AIDS (PWHA) is a major factor fueling negative community reactions. In fact, interviews indicate that positive moral judgments of the PWHA’s general character are more common and often elicit concern, sympathy, and support.
