ATENCIN CULTURALMENTE PERTINENTE ES ESENCIAL PARA LA ADHERENCIA DE PERSONAS MAYAS VIH POSITIVA EN GUATEMALA

Culturally appropriate integrated care is essential for the Adherence of Indigenous Persons Infected with HIV in Guatemala

Angel R. Solval, Lic. Janet M. Ikeda, M.A.Norman Hearst, M.D., M.Ph.

Location of the Integrated Care Clinic Dr. Issac Cohen Alcah

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 sexEthnic GroupPreference and comprehension of language among Mayan peoples. OccupationPromedio de ingreso mensual:Q.729.00EducationReligionART by Sex groupPersons with ART by Ethnic GroupLessons Learned: Adherence Levels by ethnic group16Lessons LearnedIt 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 infectedPart of LifeCARGA or ChallengeThere isnt a feeling that anyone should be blamedThe person accepts their condition as HIV positive personActions are oriented to improve their future. Is a responsabilityAn opportunity to raise their values to another levelTo devote themselves to self-careThey 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(Kamal Be)

Challenge/Candidates for Service(Eqomal)

Sick Person (yawab)

Lessons LearnedThere are persons in ones life that can help with the adherence.

Use religion or spirituality to improve ART treatment.

Recieve Family AssistanceNext StepsDialogue 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