Niphattra Haritavorn

HIV AND AIDS, STIGMA AND AIDS SUPPORT GROUPS: PERSPECTIVES FROM WOMEN LIVING WITH HIV AND AIDS IN CENTRAL THAILAND

In this paper, community attitudes toward women living with HIV and AIDS at the present time from the perspectives of women in Thailand are examined. We also look at strategies women use in order to deal with any stigma and discrimination that they may feel or experience in the community. The paper is based on our larger study of the experiences of women living with HIV and AIDS and their participation in clinical trials. In late 2007 and early 2008 we carried out a number of in-depth interviews with women living with HIV and AIDS in central Thailand. We find that women living with HIV and AIDS still deal with stigma and discrimination in their everyday life. However, from the womens narratives, we also find more positive attitudes from local communities. Some women deal with stigma and discrimination by joining and participating in HIV and AIDS support groups that have emerged in response to the AIDS epidemic in Thailand. We argue that women are not passive victims, but that they act in their own agencies to counteract any negativity they might encounter.

Living Positively: The Experiences of Thai Women Living With HIV/AIDS in Central Thailand

Living with an incurable illness such as HIV/AIDS is a stressful experience. However, many HIV-positive individuals are able to maintain their emotional well-being. This begs the question of what strategies these individuals employ to allow them to do so. In this article, we examine how Thai women living with HIV/AIDS learned about their health status, what feelings they had, and how they dealt with the illness. In-depth interviews were conducted with 26 women in central Thailand. The women adopted several strategies to deal with their HIV status, including taking care of themselves, accepting their own faith, disclosing their HIV status to family, and joining AIDS support groups. These strategies can be situated within the “living positively” discourse, which helped to create a sense of optimism to combat the HIV epidemic among the women. Additionally, the acceptance of their HIV status played an essential role in the meaning-making process because it assisted the women in sustaining the equilibrium of their emotional well-being.

To tell or not to tell: disclosure to children and family amongst Thai women living with HIV/AIDS

HIV disclosure is a complex phenomenon. The choice of disclosure or non-disclosure is a reflection of how each HIV-positive person experiences and deals with HIV/AIDS in their everyday life. In this study, we qualitatively explore the experiences of disclosing HIV status to family members and children among HIV-positive women living in Thailand. Due to fear of stigma and discrimination, the women decided to tell only a few people, usually their significant others including parents and children. Although most women received good support from their family members, some were rejected and discriminated against by their family members. This stems from lack of knowledge about HIV/AIDS among family members. Women found disclosure to their children a difficult decision to make. Only some women told their children about their HIV status. They wished to protect their children from emotional burden. This protection also appeared in their attempts to prepare their children for dealing with HIV/AIDS. Support from family members played a major role in the lives of HIV-positive women. Although disclosure has been promoted as a means of ending stigma and discrimination, our data suggested that disclosure may not be positive for some women. This has implications for health promotion in HIV health care. Healthcare providers need to appreciate the ramifications of promoting disclosure to HIV-positive women who are mothers.

Local Discourse on Antiretrovirals and the Lived Experience of Women Living With HIV/AIDS in Thailand

Antiretrovirals (ARVs) have been seen as life-saving for HIV-positive people. However, ARVs have a darker side. Since 2000, many HIV-positive people in Thailand have received ARV treatments, but the understanding of ARVs and practices of medication-taking among HIV-positive women have not received much attention. We discuss local discourses employed by HIV-positive women and health work by these individuals in their attempts to adhere to ARVs restrictions. The local discourse of ARVs was ya tan rok AIDS “medications that could resist HIV/AIDS.” ARVs provided hope for the women. Although the women were affected by the side effects of ARVs, they continued to take their medication to be able to live longer and perform their duties as mothers and carers. They were more concerned about the practice of medication-taking. Understanding why these women were adherent to their ARVs offers insights into the social impact of these ARVs on their lives.

My life as Mae Tid Chua [mothers who contracted HIV disease]: Motherhood and women living with HIV/AIDS in central Thailand

BACKGROUND literature suggests that many women living with HIV/AIDS have a desire to become mothers and indeed many of them have done so (Thiangtham and Bennett, 2009; Barnes, 2013; Cogna et al., 2013; Lazarus et al., 2013; Ross, 2013; Yeatman and Trinitapoli, 2013). However, there is still a lack of knowledge about the lived experiences of Thai women living with HIV/AIDS who have become mothers. In this paper, we explored the experiences of pregnancy and birth, motherhood, and infant feeding practices among women living with HIV/AIDS in Thailand. METHOD in-depth interviews were conducted with 26 women living with HIV/AIDS in Thailand. FINDINGS motherhood was considered desirable by women living with HIV/AIDS who participated in our study. Despite living with a serious illness, becoming a mother permitted them to have a meaningful life. Motherhood prompted the women to stay alive for their children. However, the women lived with constant anxiety about the condition of their infants. Reproductive needs of the women in our study were often questioned by their health care providers. Many were advised by their doctors and nurses not to breast feed their newborn babies as this could transmit HIV to the child. Most women took into account their ability to care for their children in the future and thus did not wish to have many children. CONCLUSION this paper contributes to conceptual understanding about the lived experiences of motherhood among women living with HIV/AIDS in Thailand. The findings have implications for midwifery care.

Surviving in two worlds: Social and structural violence of Thai female injecting drug users

Thai females injecting drugs are ensnared in a web of problems arising from forms of prejudice that magnify their vulnerability. They are vulnerable, at risk, and exposed to a high degree of social suffering. This paper aims to elucidate how social production and structural violence combine to shape the lives of these women. Using a qualitative methodology, two focus groups with 5 key informants and in-depth interviews involving a total of 35 women injecting drugs were conducted in Bangkok. The findings reveal that the structural environment that directly impacts upon these womens lives becomes the reason for their suffering. The structural environment puts these women at risk of violence in numerous social settings in which these women engage as well as generating tension at a subjective level (i.e. the habitus) of these women. Thai female injecting drug users are trapped in a difficult tension between the demands for being Thai women seeking to exist in the masculine world of drug use but at the same time meeting Thai societys expectations of womanhood. Unequal gender relations are manifest in the everyday violence that women face in the drug community, culminating in the essential nature of women being questioned, undermined and threatened. Living in the drug community, women are subjected to violence and harassment, and gendered brutality by intimate partners. In conclusion, the social suffering that Thai female injecting drug users find themselves confronting is confined to dilemmas cause by tensions between drug use and the overriding gender habitus.

AIDS Support Groups and Women Living with HIV/AIDS in Central Thailand

In this chapter, we examine community attitudes toward women living with HIV/AIDS in Thailand. We also look at strategies employed by women in order to deal with any stigma and discrimination that they may feel or experience in the community. The chapter is based on our larger study of the experiences of women living with HIV/AIDS and their participation in clinical trials in Thailand. We carried out a number of in-depth interviews with women living with HIV/AIDS in central Thailand. We find that women living with HIV/AIDS still deal with stigma and discrimination in their everyday life. However, from the women’s narratives, we also find more positive attitudes from local communities. Women deal with stigma and discrimination by joining and participating in HIV/AIDS support groups that have emerged in response to the AIDS epidemic in Thailand. We argue that women are not passive victims but that they act in their own agencies to counteract any negativity they might encounter.

Participating in HIV Clinical Trials: Reasons and Experiences Among Women Living With HIV in Thailand

The authors discuss the experiences of participating in HIV trials and their ethical concerns among Thai women living with HIV/AIDS. In-depth interviews and participant observations were conducted with 26 Thai women. Due to their vulnerability and poverty, HIV trials were particularly attractive to these women. Reasons included personal protection from infection, personal gains (free medication, medical care, and information about the development of future clinical trials), and social altruism. The attempts of the women to stay healthy and live longer by participating in clinical trials can be seen as health-promoting behavior. Participation in clinical trials helped to create a sense of optimism to combat the HIV epidemic. The participation also assisted the women to sustain the equilibrium of their emotional well-being. These findings can be valuable for the design and conduct of future HIV clinical trials and the provision of sensitive HIV care for women who are the vulnerable members of society.

Women, motherhood, and living positively : the lived experience of Thai women living with HIV/AIDS

Living with an incurable illness such as HIV/AIDS is a stressful experience. However, many HIV-positive individuals are able to maintain their emotional well-being. This begs the question of what strategies these individuals employ to allow them to do so. In this chapter, we examine how Thai women who are mothers and living with HIV/AIDS dealt with the illness. In-depth interviews were conducted with 26 women in central Thailand. The women adopted several strategies to deal with their HIV status including taking care of own self, accepting one’s own faith, disclosing their HIV status to family, and joining AIDS support groups. These strategies can be situated within the “living positively” discourse which helps to create a sense of optimism to combat the HIV epidemic among the women. Additionally, the acceptance of their HIV status plays an essential role in the meaning-making process because it assists the women to sustain the equilibrium of their emotional well-being.