Book contents
- Frontmatter
- Contents
- List of contributors
- Preface
- 1 Medical overview
- 2 Cognitive disorders in people living with HIV disease
- 3 General principles of pharmacotherapy for the patient with HIV infection
- 4 Mood disorders and psychosis in HIV
- 5 Suicidal behavior and HIV infection
- 6 Anxiety disorders and HIV disease
- 7 General issues in hospital HIV psychiatry
- 8 HIV and people with serious and persistent mental illness
- 9 Psychotherapy
- 10 HIV and substance use disorders
- 11 Psychiatric issues in pediatric HIV/AIDS
- 12 Uninfected children of parents with HIV
- 13 Psychological issues faced by gay men
- 14 Women and HIV
- 15 Couples
- 16A HIV and cultural diversity
- 16B African Americans
- 16C Latinos and HIV disease
- 16D One heart, two spirit, and beyond: HIV and the people of the First Nations
- 17 HIV in prison populations
- 18 Legal and ethical issues
- 19 Psychiatrist as caregiver
- Appendix I HIV Counselling checklist for physicians
- Index
- References
16A - HIV and cultural diversity
Published online by Cambridge University Press: 06 August 2009
- Frontmatter
- Contents
- List of contributors
- Preface
- 1 Medical overview
- 2 Cognitive disorders in people living with HIV disease
- 3 General principles of pharmacotherapy for the patient with HIV infection
- 4 Mood disorders and psychosis in HIV
- 5 Suicidal behavior and HIV infection
- 6 Anxiety disorders and HIV disease
- 7 General issues in hospital HIV psychiatry
- 8 HIV and people with serious and persistent mental illness
- 9 Psychotherapy
- 10 HIV and substance use disorders
- 11 Psychiatric issues in pediatric HIV/AIDS
- 12 Uninfected children of parents with HIV
- 13 Psychological issues faced by gay men
- 14 Women and HIV
- 15 Couples
- 16A HIV and cultural diversity
- 16B African Americans
- 16C Latinos and HIV disease
- 16D One heart, two spirit, and beyond: HIV and the people of the First Nations
- 17 HIV in prison populations
- 18 Legal and ethical issues
- 19 Psychiatrist as caregiver
- Appendix I HIV Counselling checklist for physicians
- Index
- References
Summary
Introduction
Disease does not occur in a vacuum. It occurs in a specific cultural context which determines how the illness will be identified, interpreted, and managed. Culture is a social matrix that includes the ethnocultural background of both patient and clinician, as well as the knowledge and practices that each brings to understanding and treating illness (Kirmayer et al., 2003). Cultures are not fixed, stable entities. They are fluid and dynamic, especially in the face of globalization which increases tension between local worlds and global trends (Bibeau, 1997).
In pluralistic societies, cultural diversity is both a source of richness and a clinical challenge. Culture-related barriers to healthcare range from language to poor adherence (which has been documented frequently but is still not well understood) (Beiser, 1988). Unfortunately, healthcare providers tend to focus on cultural differences and de-emphasize the role that specific cultural value systems, coping strategies, and solidarity networks can play in the healing process or in framing chronic illnesses.
Different countries have developed a variety of models for culturally appropriate care, which tend to reflect the historical, social, and political orientations of mainstream societies. For example, the UK model focuses on avoiding racism, the US model attempts to match patients with clinicians from the same ethnic background, while the Australian and Canadian models focus on developing culturally competent healthcare providers who are able to provide culturally responsive services (Kirmayer and Minas, 2000).
To address cultural dimensions in clinical care, clinicians will identify:
their own personal, professional, and institutional subcultures
how these may shape the clinician–patient interaction.
- Type
- Chapter
- Information
- HIV and PsychiatryTraining and Resource Manual, pp. 248 - 252Publisher: Cambridge University PressPrint publication year: 2005