‘When whites catch a cold, black folks get pneumonia’: a look at racialized poverty, space and HIV/AIDS

Batelaan, Krystal

doi:10.1080/13504630.2020.1823827

Cited by 10 publications

(6 citation statements)

References 21 publications

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“…Eliminating structural forms of violence and advancing social justice is timely, given the documented disproportionate impact of the COVID-19 pandemic on Black and racialized communities, particularly those living with HIV [125]. The syndemic of COVID-19, HIV, comorbidities, and racial inequities among Black communities foreground the need to centre social injustices including systemic and anti-Black racism in research.…”

Section: Discussionmentioning

confidence: 99%

Structural violence and the uncertainty of viral undetectability for African, Caribbean and Black people living with HIV in Canada: an institutional ethnography

Odhiambo

O’Campo

Nelson

et al. 2023

Int J Equity Health

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Biomedical advances in healthcare and antiretroviral treatment or therapy (ART) have transformed HIV/AIDS from a death sentence to a manageable chronic disease. Studies demonstrate that people living with HIV who adhere to antiretroviral therapy can achieve viral suppression or undetectability, which is fundamental for optimizing health outcomes, decreasing HIV-related mortality and morbidity, and preventing HIV transmission. African, Caribbean, and Black (ACB) communities in Canada remain structurally disadvantaged and bear a disproportionate burden of HIV despite biomedical advancements in HIV treatment and prevention. This institutional ethnography orients to the concept of ‘structural violence’ to illuminate how inequities shape the daily experiences of ACB people living with HIV across the HIV care cascade. We conducted textual analysis and in-depth interviews with ACB people living with HIV (n = 20) and health professionals including healthcare providers, social workers, frontline workers, and health policy actors (n = 15). Study findings produce a cumulative understanding that biomedical HIV discourses and practices ignore structural violence embedded in Canada’s social fabric, including legislation, policies and institutional practices that produce inequities and shape the social world of Black communities. Findings show that inequities in structural and social determinants of health such as food insecurity, financial and housing instability, homelessness, precarious immigration status, stigma, racial discrimination, anti-Black racism, criminalization of HIV non-disclosure, health systems barriers and privacy concerns intersect to constrain engagement and retention in HIV healthcare and ART adherence, contributing to the uncertainty of achieving and maintaining undetectability and violating their right to health. Biomedical discourses and practices, and inequities reduce Black people to a stigmatized, pathologized, and impoverished detectable viral underclass. Black people perceived as nonadherent to ART and maintain detectable viral loads are considered “bad” patients while privileged individuals who achieve undetectability are considered “good” patients. An effective response to ending HIV/AIDS requires implementing policies and institutional practices that address inequities in structural and social determinants of health among ACB people.

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Section: Discussionmentioning

confidence: 99%

Structural violence and the uncertainty of viral undetectability for African, Caribbean and Black people living with HIV in Canada: an institutional ethnography

Odhiambo

O’Campo

Nelson

et al. 2023

Int J Equity Health

View full text Add to dashboard Cite

show abstract

“…Studies show that interventions focusing on training healthcare providers on cultural competency improve providers' understanding of culturally responsive healthcare and services and strengthen the patient-provider relationship (122,123). Eliminating structural forms of violence and advancing social justice is timely, given the documented disproportionate impact of the COVID-19 pandemic on Black and racialized communities, particularly those living with HIV (124). The syndemic of COVID-19, HIV, comorbidities, and racial inequities among Black communities foreground the need to centre social injustices including systemic and anti-Black racism in research.…”

Section: Discussionmentioning

confidence: 99%

Structural Violence and the Uncertainty of Viral Undetectability for African, Caribbean and Black People Living with HIV in Canada: An Institutional Ethnography

Odhiambo

O’Campo

Nelson

et al. 2022

Preprint

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Biomedical advances in healthcare and antiretroviral treatment or therapy (ART) have transformed HIV/AIDS from a death sentence to a manageable chronic disease. Studies demonstrate that people living with HIV who adhere to antiretroviral therapy can achieve viral suppression or undetectability, which is fundamental for optimizing health outcomes, decreasing HIV-related mortality and morbidity, and preventing HIV transmission. African, Caribbean, and Black (ACB) communities in Canada remain structurally disadvantaged and bear a disproportionate burden of HIV despite biomedical advancements in HIV treatment and prevention. This institutional ethnography orients to the concept of ‘structural violence’ to illuminate how inequities shape the daily experiences of ACB people living with HIV across the HIV care cascade. We conducted textual analysis and in-depth interviews with ACB people living with HIV (n=20) and health professionals including healthcare providers, social workers, frontline workers, and health policy actors (n=15). Study findings produce a cumulative understanding that biomedical HIV discourses and practices ignore structural violence embedded in Canada’s social fabric, including legislation, policies and institutional practices that produce inequities and shape the social world of Black communities. Findings show that inequities in structural and social determinants of health such as food insecurity, financial and housing instability, homelessness, precarious immigration status, stigma, racial discrimination, anti-Black racism, criminalization of HIV non-disclosure, health systems barriers and privacy concerns intersect to constrain engagement and retention in HIV healthcare and ART adherence, contributing to the uncertainty of achieving and maintaining undetectability and violating their right to health. Biomedical discourses and practices, and inequities reduce Black people to a stigmatized, pathologized, and impoverished detectable viral underclass. Black people perceived as nonadherent to ART and maintain detectable viral loads are considered “bad” patients while privileged individuals who achieve undetectability are considered “good” people. An effective response to ending HIV/AIDS requires implementing policies and institutional practices that address inequities in structural and social determinants of health among ACB people.

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“…These limitations may include racialised poverty (Batelaan, 2021), youth criminalisation (Jiwani and Al-Rawi, 2019), the inferiorisation of African Canadian parental styles (Adjei and Minka, 2018) and systemic anti-black racism/Afrophobia and the history of colonisation and slavery. These systemic limitations make African Canadian students alienated and disenchanted with the school, leading to a microculture of disinterest in school, culminating in further stigmatisation, dropouts and criminalisation.…”

Section: The Cycle Of Misrepresentationmentioning

confidence: 99%

Back to ‘things themselves’: breaking the cycle of misrepresentation when serving African Canadian youth

Garang

2022

Critical and Radical Social Work

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Bureaucratic discourses informed by legacies of slavery and colonisation create traumatising experiences among African Canadian youth in social, educational and law-enforcement institutions in Canada. These discourses create the already-known-people paradigm and are then exacerbated by the effects of neoliberal policies and managerialist administrations to produce an unfortunate social condition in which system professionals discount what these youth say about experiential marginality and social injustice. This means that African Canadian youth end up being understood by system professionals from administrative discourses or from historical assumptions. Using phenomenology, I argue in this article that focusing on the experiences of these youth in time when assessing or making decisions about them may help to reduce stereotyping and stigmatisation, and to highlight normalised social injustices. Consequently, focusing on behaviour-in-time as opposed to behaviour-in-discourse may allow system professionals to operationalise administrative discourses without downplaying behaviour-in-time, which is important in service provision.

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‘When whites catch a cold, black folks get pneumonia’: a look at racialized poverty, space and HIV/AIDS

Cited by 10 publications

References 21 publications

Structural violence and the uncertainty of viral undetectability for African, Caribbean and Black people living with HIV in Canada: an institutional ethnography

Structural violence and the uncertainty of viral undetectability for African, Caribbean and Black people living with HIV in Canada: an institutional ethnography

Structural Violence and the Uncertainty of Viral Undetectability for African, Caribbean and Black People Living with HIV in Canada: An Institutional Ethnography

Back to ‘things themselves’: breaking the cycle of misrepresentation when serving African Canadian youth

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