AIDSImpact.com:: - Santa Fe, USA 2011

Abstract #46 - The decline of social proximity to the HIV/AIDS Epidemic in South Africa and Brazil: consequences for an adequate response to the epidemic
Authors: Presenting Author: Professor Carl Kendall - Tulane University
Additional Authors: Dr. Ligia Kerr, Dr. Alexandre Vale,
Aim: Discuss social proximity to the HIV epidemic* in South Africa and Brazil, especially the effect of the availability of antiretroviral therapy, and its impact on prevention. *Macintyre K, Kendall C. Steps to a new theory of social proximity of the HIV epidemic and behavior change, in Aids, Culture and Africa. D Feldman (ed.), University Press of Florida, 2008
Method / Issue: Social proximity was developed to describe social and cultural conditions that influenced the salience and "impendingness" of the HIV epidemic, the public willingness to overcome denial and create an environment for openness to change. The concept, developed in light of historical epidemics in San Francisco in the early '80's and Uganda in the 90's did not address the impact of the availability of antiretroviral therapy on social proximity. The Community Response to the Availability of ARVs in three Districts in South Africa Study 2004-2006 (USG Cooperative Agreement No. U62/CC2622410) conducted in a country with a generalized epidemic and the Resistance to HIV Testing in Fortaleza Study (ANRS) 2010-2012, in a country with a concentrated epidemic both conducted rapid anthropological assessment (RAA). These sources are used to explore general community and HIV affected individuals’ perceptions of the epidemic and changes since the introduction of ARVs.
Results / Comments: Data from these two studies document the retreat from the sense of proximity to the epidemic and the new strategies for maintaining denial that are now found
Discussion: Social proximity has implications for understanding the persistence of the epidemic, and how to set the mix of clinical and preventive interventions. The indirect effects of interventions that reduce population-level social distance to the epidemic are critical to ensure uptake of testing and early treatment. Examples of interventions and measurement of social proximity are also discussed.
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