The conduct of interactions between care providers and HIV migrants patients in a context of austerity: an exploratory review of AIDS care communicational processes in French Belgium

TitleThe conduct of interactions between care providers and HIV migrants patients in a context of austerity: an exploratory review of AIDS care communicational processes in French Belgium
Publication TypeConference Paper
Author(s)Aline, K.
Affiliation (1st Author)Université catholique de Louvain, Mons Chaussee de Binche 151 7000 Mons Belgium
Section or WGCommunication and HIV/AIDS Working Group
DateThurs 27 June
Slot CodeCHAT4a
Slot Code (Keyword)CHAT4a
Time of Session16:00-17:30
Session TitleSocial Determinants: Gender and Power Issues in HIV/AIDS and Health
Submission ID6269

How do political dynamics of asylum and migration influence the practice of daily AIDS care providers at local level of services in french belgium, through the lens of doctor-patient interaction ?This presentation aims to discuss the exploratory results of an ongoing research on the conduct of interactions between care providers and HIV-positive patients within the institutional context of French Belgium (local level). We suggest that collaborative and long-term construction of care, studied from the conduct of interactions, can bring understanding on the complexity of processes in organizational communication of care institutions. We also illustrate how an ethnographic approach, based on fieldwork observations, can explain the burden of crisis measures focusing on reducing migration in Europe on day-to-day work life in care center. Fieldwork observations of doctor-patient interactions illustrate that reforms and austerity measures, due to the economic crisis, have a significant impact on the situation of migrants AIDS patients in Belgium and their therapeutic care within specialized centers for AIDS care. An ongoing fieldwork research in one of these clinics, where half of the patients are migrants, reveals empirical data’s of an increasingly investment of actors (doctors) in the patient’s regularization procedure to cope with tighter eligibility conditions. This paper aims to analyze, grounding on empirical data, communicational processes of negotiation, collaboration and assistance between migrant patients (mostly africans), their clinician and lawyer, co-invested in a medical regularization procedure due to AIDS. Since the introduction of a "medical filter," OE physicians (Foreign Office, state level) are responsible to review and reject any application for regularization due to medical reasons if the disease can be threated in the country of origin. Then, the regularization refusal is supported by official data released by WHO and African states ,, the more frequent argument for refusal has become that access to first generation antiretroviral treatment officially appears effective in these African states. Observations and analysis on official documents indicate that Belgian care providers are more likely to see their arguments rejected massively on the basis that AIDS is to be considered by institutionnal authorities as a homogeous disease that requires antiretroval treatments as well undifferentiated. Hence, the understanding of these processes are to be linked to a twofold paradigmatic conception of AIDS ,, a mainstream discourse considers constant evolution of HIV from an epidemic and acute disease to a chronic pathology in Western countries. On the other hand, the situation in Africa points out the epidemic diffusion of HIV. Therefore, empirical situation here described underlines a peculiar dualistic status of AIDS within biological sciences. BIBLIOGRAPHY Chu C. & Selwyn P.A., (2011), An epidemic in evolution,, the need for new models of HIV care in the chronic disease era, Journal of Urban Health, , vol. 88. Cooren F., (2010), Action and agency in dialogue,, Passion, incarnation and ventriloquism, Amsterdam/Philadelphia, John Benjamins Publishing Company. McCoy L., (2005), HIV-Positive Patients and the Doctor-Patient Relationship,, Perspectives From the Margins, Qualitative Health Research, vol. 15. Reece M., Tanner A., Karpiak S., Coffey K., (2007), The impact of HIV- related stigma on HIV care and prevention providers, Journal of HIV/AIDS & Social Services, vol.6.

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