Structural actions toward HIV/AIDS prevention in Cartagena, Colombia: a qualitative study Medidas estructurales para la prevención de la infección por el VIH/sida en Cartagena, Colombia: estudio cualitativo

• Main Authors: María Cristina Quevedo-Gómez, Anja Krumeich, César Ernesto Abadía-Barrero, Eduardo Manuel Pastrana-Salcedo, Hubertus van den Borne
• Format: Article in Journal/Newspaper
• Language: English; Spanish; Portuguese
• Published: Pan American Health Organization 2011
• Subjects: VIH; SIDA; etnografía; medio social; investigación cualitativa; Colombia; HIV infections; AIDS; ethnography; social environment; qualitative research; Medicine; R; Arctic medicine. Tropical medicine; RC955-962; Public aspects of medicine; RA1-1270; Arctic; Sida
• Online Access: https://doaj.org/article/edfbf06c867e4fae9974c8fade4cef40

OBJECTIVE: To obtain a thorough understanding of the complexity and dynamics of the social determination of HIV infection among inhabitants of Cartagena, Colombia, as well as their views on necessary actions and priorities. METHODS: In a five-year ethnography of HIV/AIDS in collaboration with 96 citizens of Cartagena, different methods and data collection techniques were used. Through 40 in-depth interviews and 30 life histories of inhabitants, the scenario of HIV vulnerability was summarized in a diagram. This diagram was evaluated and complemented through group discussions with key representatives of local governmental and nongovernmental organizations and with people who were interested in the epidemic or affected by it. RESULTS: The diagram illustrates the dynamic and complex interrelationships among structural factors (i.e., social determinants) of HIV infection, such as machismo; lack of work, money, and social services; local dynamics of the performance of the state; and international dynamics of the sexual tourism industry. On the basis of the diagram, groups of key representatives proposed prioritizing structural actions such as reducing socioeconomic inequalities and providing access to health care and education. CONCLUSIONS: The social determinants displayed in the diagram relate to historic power forces that have shaped vulnerable scenarios in Cartagena. Collaboration between participants and researchers generates conceptual frameworks that make it possible to understand and manage the complexity of HIV's social determination. This way of understanding effectively connects local inequalities with international flows of power such as sexual tourism and makes evident the strengths and limitations of current approaches to HIV prevention. OBJETIVO: Explorar la comprensión de los habitantes sobre la determinación social de la infección por el VIH en Cartagena, Colombia, y sus criterios sobre las medidas necesarias y las prioridades. MÉTODOS: Se usaron diferentes métodos y técnicas de recolección de datos ...