Location of the Integrated Care
Clinic ¨Dr. Issac Cohen Alcahé¨
Principal Areas where Indigenous
Peoples live
Issue:
 Official AIDS cases in Guatemala are not reported by
ethnic groups.
 There are a large percentage of persons living with
HIV/AIDS that are from the Mayan ethnic groups.
 Our hypothesis is that culture is the foundation for
integrated care of Indigenous persons living with HIV.
Objetivo
We implemented this study to
describe concrete elements that
secure cultural respect and can be
integrated in adherence counseling
for this underserved population.
Description:
 We implemented a study among 240 Indigenous
persons infected with HIV from the integrated care
clinic in Quetzaltenango, Guatemala.
 We designed, validated and administrated a
structured questionnaire that measures: demography,
experiences in HIV integrated care clinics,
socioeconomic and cultural factors that influence in
adherence and integrated care, the need to speak in
the Indigenous language, concepts regarding sickness
and health, spiritual and religious perceptions.
Characterization of Group:
Ethnic Groups by sex
Male, Maya, 62%
Male, Mestizo, 55%
Female, Mestizo, 45%
Female, Maya, 38%
Male
Female
Ethnic Group
Chart Title
Total, Mestizo, 70, 27%
Maya
Total, Maya, 194, 73%
Mestizo
Preference and comprehension of
language among Mayan peoples.
Series1, Maya, 83, 30%
Series1, Spanish, 194, 70%
Maya
Spanish
Occupation
Series1, Construction, 22,
8%
Series1, Student, 2, 1%
Series1, Artesanal
activities, 34, 13%
Series1, Informal Sector, 66,
25%
Informal Sector
Series1, No employment, 42,
16%
Housewives
Series1, Housewives, 56, 21%
Agricultural workers
No employment
Artesanal activities
Series1, Agricultural
workers, 42, 16%
Construction
Student
Promedio de ingreso mensual:
Q.729.00
Education
Series1, Completed primary
school, 33, 12%
Series1, University, 8, 3%
Series1, Junior and High
School, 34, 13%
Series1, Incomplete primary
school, 95, 36%
Incomplete primary school
No schooling
Junior and High School
Completed primary school
University
Series1, No schooling, 94,
36%
Religion
Series1, Other, 3, 1%
Series1, None, 36,
14%
Series1, Catholic, 72,
27%
Series1, Evangelical,
153, 58%
Evangelical
Catholic
None
Other
ART by Sex group
Male, With ART, 81%
Female, With ART, 80%
Female
Male
Female, Without ART,Male,
20% Without ART, 19%
Persons with ART by Ethnic Group
Maya
Mestizo
Lessons Learned: Adherence
Levels by ethnic group
Mestizo
Maya
Lessons Learned
 It was necessary to explain HIV/AIDS, ART treatment
and the nature of ART medication in the Mayan
language within the socio-cultural context of the
person.
 70% of the Indigenous patients manage a different
concept of sickness and health than the western
perspective.
Sickness and health is based on
communal perceptions rather than individualistic
aspects.
How to interpret what it means to
be HIV infected
Mestizo
Maya
Part of Life
CARGA or Challenge
There isn´t a feeling that anyone should be
blamed
The person accepts their condition as HIV
positive person
Actions are oriented to improve their future.
Is a responsability
An opportunity to raise their values to
another level
To devote themselves to self-care
They have a personal goal that their life will
be useful and dedicated to serving others.
It is their hope that they will become a great
person and community leader.
Leaders
(K’amal B’e)
Challenge/Candidates for Service
(Eqomal)
Sick Person (yawab’)
Lessons Learned
 There are persons in one´s life that can help with the
adherence.
 Use religion or spirituality to improve ART treatment.
Recieve Family Assistance
Mestizo
Maya
Next Steps
 Dialogue about HIV and AIDS as part of the oral
tradition, transmiting a vision of NO discrimination
among HIV+ persons.
 Advocate among leaders and community authorities to
bring support to the integrated care HIV clinics (this
includes assisting with adherence to HIV therapy)
 Propose to other integrated care clinics to take steps in
complementing the vision that the Indigenous
populations have regarding sickness and health.
Thank You
Descargar

atención culturalmente pertinente es esencial para la adherencia de