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

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 Alcahé ¨.

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

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

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

  3. Location of theIntegratedCareClinic ¨Dr. Issac Cohen Alcahé¨

  4. Principal AreaswhereIndigenousPeopleslive

  5. 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.

  6. Objetivo We implemented this study to describe concrete elements that secure cultural respect and can be integrated in adherence counseling for this underserved population.

  7. 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.

  8. Characterization of Group: EthnicGroupsby sex

  9. EthnicGroup

  10. Preference and comprehension of languageamong Mayan peoples.

  11. Occupation Promedio de ingreso mensual: Q.729.00

  12. Education

  13. Religion

  14. ART by Sex group

  15. Personswith ART byEthnicGroup

  16. LessonsLearned: AdherenceLevelsbyethnicgroup

  17. LessonsLearned • 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.

  18. Howtointerpretwhatitmeanstobe HIV infected

  19. Part of Life Thereisn´t a feelingthatanyoneshouldbeblamed Thepersonacceptstheircondition as HIV positive person Actions are orientedtoimprovetheirfuture. Is a responsability Anopportunitytoraisetheirvaluestoanotherlevel To devote themselvestoself-care Theyhave a personal goalthattheirlifewillbeuseful and dedicatedtoservingothers. Itistheir hope thattheywillbecome a greatperson and community leader. CARGA orChallenge

  20. Leaders (K’amalB’e) Challenge/CandidatesforService (Eqomal) SickPerson (yawab’)

  21. LessonsLearned • There are persons in one´s life that can help with the adherence. • Use religion or spirituality to improve ART treatment.

  22. RecieveFamilyAssistance

  23. NextSteps • Dialogue about HIV and AIDS as part of the oral tradition, transmiting a vision of NO discriminationamong HIV+ persons. • Advocateamongleaders and communityauthoritiestobringsupporttotheintegratedcare HIV clinics (thisincludesassistingwithadherenceto HIV therapy) • Proposetootherintegratedcareclinicstotakesteps in complementingthevisionthattheIndigenouspopulationshaveregardingsickness and health.

  24. ThankYou

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