HIV stigma and discrimination in medical settings: stories from African women in New Zealand.

Recent changes in New Zealand's HIV and immigration situations have sparked a need to understand the experiences of HIV-positive African newcomers there. Here a narrative lens was brought to a previous qualitative study to harvest stories about discrimination in medical settings in New Zealand, told by four HIV-positive African women. Despite describing positive experiences with specialist HIV providers, their accounts shed light on weaknesses within the health care system regarding the rights and treatment of immigrants living with HIV.

HIV diagnosis disclosure: stigma management and stigma resistance.

This article reports diagnosis disclosure decision comments arising serendipitously in five focus group discussions with 34 HIV-infected New Yorkers over age 50. Three overarching disclosure themes demonstrate the complexity of diagnosis disclosure decision-making: (a) hiding or selectively disclosing, or stigma management; (b) partial disclosure because of the perception of partial control of the information; and (c) widespread or complete voluntary diagnosis disclosure, representing stigma resistance. Social workers and other human services practitioners should remember the diversity in the HIV population, the aging population, and the HIV-positive aging population.

Mama Jaja: the stresses and strengths of HIV-affected Ugandan grandmothers.

This paper reports an exploratory qualitative project in the Entebbe-Kampala area of Uganda with 11 grandmothers who are raising orphans because of a parent's death from HIV infection. In Sub-Saharan Africa, the highest HIV infection and mortality rates are among women, especially in their childbearing years, leading to a tremendous number of orphaned HIV-infected and -affected children. Uganda has the world's highest rate of HIV-affected orphans.

The lion at the gate: an HIV-affected caregiver resists stigma.

This article examines two bounded stories of HIV stigma told by an older woman who took care of her adult son as he died of AIDS. Her self-definition as a protector of her dying son was challenged when she encountered ostracism and prejudice. Her words and expressions illuminate her confrontation and resistance to associative stigma.

Unserved, unseen, and unheard: integrating programs for HIV-infected and HIV-affected older adults.

This article explores the parallel structures and service delivery systems of the Older Americans' Act and the Ryan White CARE Act, argues that social workers should have a working knowledge of both pieces of public policy, and suggests integration or coordination of aging and HIV services. Two vignettes illuminate the issues and implications for HIV and aging network social workers. The authors argue that HIV social workers should know more about services for older people and that gerontological social workers should know more about HIV services so that HIV-infected and HIV-affected older people do not remain unserved, unseen, and unheard.

Medical profiling: narratives of privilege, prejudice, and HIV stigma.

In this article, the author uses selected narrative analysis methods to deconstruct stories presented in separate interviews by a married couple who believe that their HIV-infected adult daughter has been victimized by medical profiling. In their accounts, they construct their belief that their daughter's gender, race, education, appearance, and socioeconomic status contributed to her not receiving an accurate diagnosis despite repeated medical examinations. Their similar accounts paint a picture of parents frantically seeking a diagnosis as symptoms worsen without explanation.

Choices and voices: participation of people with HIV on Ryan White Title II Consumer Advisory Boards.

This article presents an assessment of the functioning and training needs of consumer advisory boards in Massachusetts (CABs) who advise the Massachusetts agency and the consortia funded through Title II of the Ryan White Comprehensive AIDS Resources Emergency Act. The study found that the stage agency and the CABs valued the role of consumers in policy making, but the mechanisms for translating this goal into reality were not always clear or available. The CABs wanted more opportunities to interact with HIV/AIDS Bureau staff and with one another.

Teaching and learning by example: empowerment principles applied to development, delivery, and evaluation of community-based training for HIV service providers and supervisors.

This article describes and recommends a participatory method of developing, implementing, and evaluating a learner-driven community-based continuing education effort for HIV workers and supervisors. The Boston University School of Social Work (BUSSW) created and delivered a training program in partnership with the Massachusetts Department of Public Health HIV/AIDS Bureau (the Bureau). Because teaching empowerment-based practice was an overarching goal, every step of the process modeled collaboration and self-determination.