Quote


"The human race has one really effective weapon, and that is laughter." ~Mark Twain
Showing posts with label AIDS. Show all posts
Showing posts with label AIDS. Show all posts

Monday, August 15, 2011

Pepsi brings your ancestors back from the grave...

One (of the many things) I've learned while living abroad and traveling is the value of language. For example: in Sierra Leone, when someone asks you how you're doing (as a general greeting in English), you respond "fine." To a Sierra Leonean, responding "fine" is the standard response. To an American listener, replying "fine" would probably imply that something was wrong, because the standard response for an American is typically "good." To an American, "fine" is somewhere below "good" and, since it doesn't fit the typically, rather neutral response, "fine" actually means "not good."

Another example is a bit more serious. A friend's Thai teacher, who speaks English very well (thanks, Friends and other imported American TV shows...), was offended when an English-speaking friend told the teacher he enjoyed the teacher's "company." To an American, this would probably be a positive compliment, meaning that you're interesting, or fun, or entertaining. The Thai teacher thought his friend was referring to prostitution, associating "company" with "factory" (a derogatory term for women who are prostitutes). While it did not make sense in the context of their friendship, the Thai teacher was offended until my friend helped explain the phrase.

Beyond mere differences in language or cross-cultural missteps, there are extraordinary differences in how people interpret their native language or a secondary language and what connotations words have among different groups of people. The importance of language is constantly under debate in the United States, to the extent that being "politically correct" is now a pejorative. But, really, it shouldn't be. I understand how frustrating it can be when certain terms are considered politically incorrect and you really don't mean to offend someone. I'm in a constant conundrum over how people with darker skin color would prefer to be referred to: should I say "African American?" "Black person?" "Person whose skin has more melanin than mine and most people who are Asian?" "Person who is less likely to get skin cancer because of said increased melanin levels?" I definitely know what terms should NOT be used, but I'd prefer to use a term that doens't carry negative connotations. I wouldn't mind being called "Irish American" but I might if I was only part Irish. I do mind being called "white person" because, well, I'm not white. At the moment, I'm pretty tan, thank you very much.
When Pepsi entered the Chinese market a few years ago, the translation of their slogan "Pepsi Brings you Back to Life" was a little more literal than they intended. In Chinese, the slogan meant, "Pepsi Brings Your Ancestors Back from the Grave."
My confusion, however, is really based on my ignorance and this, I think, gets to the root of why being politically correct, or using the language with the correct denotations and connotations, is important. What are the cultural, political, and societal implications of a term? How does the use of the term frame someone or something? How does it define the insiders and the outsiders? How has it been used in the past? Now, obviously, you can never know all of this for all of the words you use, but you can try to learn.
The Dairy Association's huge success with the campaign "Got Milk?" prompted them to expand advertising to Mexico. It was soon brought to their attention the Spanish translation read "Are you lactating?"
This topic is one I think about a lot (if you can't tell already). At a friend's wedding, I got into a discussion about the use of "Oriental" to describe Asia. I protested at a friend's use of the word "Oriental" because of its negative connotations and implicit ideas of colonization and Western idealizations. He argued that the term "Asian" was not accurate in the context he wanted to refer to and vociferously challenged me to explain why everyone had to be so politically correct (as a pejorative). I have similar objections to the simplified use of "Africa"  (This is Sierra Leone). Not that you can't use it to explain the continent, but you should not use it when using a country or regional name would be more accurate.

As a high schooler, I worked at a summer camp for children with disabilities. Note my sentence structure: "children with disabilities," not "disabled children." Why does this matter, you ask? I'll try to illustrate why with a more neutral example. I tend to be a quiet person - I'm rarely, if ever, the loudest person in the room. But that doesn't mean I want to be know as "quiet Katie." That puts one of my characteristics ahead of me! I'm also a writer, a scientist, an American, an Irish-American, a white person, a green-eyed person, a brunette, a lover of chocolate and the color purple, and a clutz with terrible hand-eye coordination. But, when you say "quiet Katie," you limit me to being one thing. Let's go back to the "children with disabilities" statement. A disabled child is just that - someone whose only characteristic is being disabled. The emphasis is on the disability rather than the child. In more formal terms, describing people this way is called "people first language."

Similar linguistic challenges occur when talking about people with HIV infection. The Joint United Nations Programme on HIV/AIDS (UNAIDS) publishes guidelines on important preferred terminology and errors to avoid. Some of the terms are just errors; for example, using the term "AIDS virus" is incorrect because there is no AIDS virus, HIV (human immunodeficiency virus) is the virus that causes AIDS. Similarly, you shouldn't say HIV virus because that's redundant. UNAIDS also adopts "people first language," emphasizing "people living with HIV," rather than "AIDS-infected" or "AIDS victim." I would argue that many of these terms can be used correctly in some situations, but only with the knowledge of how these terms are connoted.

At a recent meeting, a presenter challenged his audience to cut out the word "risk" from our vocabulary for one day. He was talking about the constant emphasis on high-risk people. He argued that people who are at high risk for HIV infection don't like being called high-risk people. It's limiting and, quite frankly, a bit insulting. A person isn't high-risk; a behavior or environment are high-risk.

So, you're probably asking yourself by now, where is she going with all of this? Well, most of it is rambling, a bit is constructively ranting, and a small part is trying to convince you to stop using the term "polically correct" as a pejorative. Yes, it can go too far, but the idea behind using accurate, non-stigmatizing, non-insulting words is important. It might be annoying to have to think constantly about the words you use... but c'est la vie.

Thursday, December 2, 2010

World AIDS Day 2010

First, a note of caution: Normally, my posts are about life in Thailand, interesting news articles, random thoughts of the day, pictures from traveling far and wide. I try not to be political or post about things that are super controversial. But, it's World AIDS Day, so here are (some) of my opinions and experiences as life as an HIV researcher.

In honor of World AIDS Day 2010, I thought I'd share some of the interesting (and disturbing) reactions from people when I tell them what I do. As you know, I am an ASPH/CDC global health fellow working with the HIV Research Branch with the Thai Ministry of Public Health - U.S. Centers for Disease Control and Prevention in Nonthaburi, Thailand. The branch is currently conducting studies among injection drug users (IDUs) and men who have sex with men (MSM). I work with the group studying behaviors and HIV among MSM in Bangkok. This, however, is quite a mouthful and I tend to summarize by saying I work in HIV research. So with this in mind, the reactions:
  1. "I hope you're not one of those people who think HIV is just in gay men." No, I'm not. Anyone CAN get infected with HIV. In Thailand, however, if you are a man who has sex with another man, you're much more likely to have HIV or to get HIV then if you're someone else. I'm not judging... I'm just saying, based on surveillance and monitoring the HIV epidemic in Thailand, this is true. This doesn't mean that MSM should be treated differently or unfairly. It actually means that, as a public health professional, I think Thailand should develop programs to prevent HIV in MSM and I think Thailand should provide support to people who have HIV. And, they are starting to. And, based on their 100% condom program, they might have success. I certainly hope so.
  2. "Hmm, should I wear a condom?" Well, yes. Using condoms consistently and correctly is one of the most effective ways at preventing HIV infection. But, really, I'm not a counselor, nor do I appreciate having this conversation on an airplane. (Actually, the question I got from my plane seat neighbor was more disturbing.) There are some other ways to prevent HIV that are currently being researched that are looking more promising:
    • Microbicides - see the CAPRISA 004 study - They demonstrated that a microbicide used by women in South Africa can decrease HIV transmission by up to 40%.
    • PrEP (Pre-Exposure Prophylaxis) - see the iPrEX study results - They demonstrated that a drug combination (Tenofovir and emtriciticine) used daily can decrease HIV transmission by about 40% (and almost 80% in those who were very adherent) in men who have sex with men in Peru, Ecuador, Brazil, United States, South Africa, and Thailand.
    • HIV vaccine - see the Thailand Vaccine Study - This was the first study that showed a vaccine had any effect in preventing HIV infections.
  3. Blank stare. "Oh that's interesting." Averted eyes. Quickly change the conversation... These people tend to be, shall we say, more conservative than others. Sometimes, they think HIV is a disease that bad people get and that people who get HIV deserve to get it. In my opinion, that's bogus. No one deserves to get a life-threatening illness. What if I said your children deserve to get diabetes because they eat too much over-processed sugars. Both can be life-threatening illnesses that require life-long treatment. Diabetes isn't heavily politicized though and people with diabetes are rarely stigmatized. Diabetes programs aren't limited by politicians in providing evidence-based prevention and treatment programs. No one says, "Hey, I think we should pay for people who have diabetes to get insulin because I don't like needles." But it happens quite frequently in HIV programs. Here are just a few examples:
    • Programs must spend a significant portion of their budget on abstinence education. Yes, I agree, abstinence is a great way of preventing the spread of HIV. But, it doesn't work by itself. Here's a pretty comprehensive review.
    • Programs cannot set up clean-needle programs for drug injectors. Look, I understand the train-of-thought: Take away access to needles and drug injectors can't inject so they can't do drugs so they can't get HIV. But that doesn't work either. Providing clean needles doesn't make injectors use drugs more often, but it can link they with treatment programs, education, and improved awareness. More information
    • Programs are limited in how they can promote condoms. There are a few lines of thinking that limit condom-promotion: 1) Condoms are a form of birth-control, which is prohibited by the Catholic church; 2) Condoms lead to promiscuity because if young people have condoms, they will have sex earlier or more often. I'm not going to address the first point (except by linking you to this article by the BBC on the Pontiff's latest remarks of condom use). The second point, however, is a bit absurd. It's along the same lines as the opposition to giving girls the HPV vaccine - if we give them the vaccine, they'll have sex earlier or more often. Really? Do you really thinking giving a girl a vaccine that can prevent a disease they may or may not get in 40 or more years will really prevent her from having sex now? Do you really think not giving a boy a condom now will prevent him from having sex now? Will all those thoughts of potential pregnancy (9 months from now) or potential for sexually transmitted diseases (which may or may not effect his health a few days to a few years from now) will prevent that? I think you're probably deluding yourself. Young people will have sex, regardless of the information or tools you provide them. So why not provide them with the best education and the best tools to prevent harmful consequences? Anyway, that's what I think.
And finally, some news from other sources on World AIDS Day 2010:

Thursday, December 3, 2009

World AIDS Day

World AIDS Day was on December 1, and several news organizations highlighted it. Here are some interesting articles:

How Obama is Changing Bush's World AIDS Plan

South Africa vows to treat all babies with HIV

U.N. report: New HIV infections decreasing

Monday, November 23, 2009

Two new acronyms

MFWIC and NCHSTP... both told to me by my mentor.

NCHHSTP (affectionately called "Nacho Stop" by my mentor, so you need to imagine this discussion with a Dutch accent) stands for National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention.

First person to get MFWIC right gets a prize.

Another sentance of acronyms I heard at a conference this week: Our funding is through PEPFAR to USAID, then FHI collaborates with HCMC PAC AIDS Center to support MSM at the Blue Sky Club.

Got that?

Monday, October 12, 2009

ASPH/CDC/TUC...

Often in the past week, I've felt like I did not understand what people around me were saying. Reasonable, right? I'm in Thailand - people speak Thai and I know only two Thai phrases thus far (hello and thank you).

Yet, most of the time, my confusion occurs around English speakers. There is, as I was repeatedly warned, another language of the CDC: acronyms. People throw them around like most people use articles (the, a, an). I've heard individuals speak entire sentences using acronyms. It's an impressive and daunting language that learning is almost as complicated as learning Thai.

In the interest of educating you (and saving my fingers from typing extra letters), here is a brief reference list of the acronyms I've come across so far.

CDC - US Centers for Disease Control and Prevention (I know, this does not make sense - the acronym should be CDCP, but historically, the office was known as the "Communicable Disease Center.")
TUC - Thailand Ministry of Public Health (MOPH) - U.S. CDC Collaboration
ASPH - Association of Schools of Public Health (an American organization)
MSM - men who have sex with men (this removes the self-identifying terms such as homosexual that many people may not accept)
HIV - human immunodeficiency virus (the virus that causes AIDS)
AIDS - acquired immune deficiency syndrome
COGH - Center for Global Health (a part of CDC)
BKK - Bangkok
ARV - antiretroviral (drugs used to help people with HIV)
PrEP - pre-exposure prophylaxis (this abbreviation is used with HIV research - if you know about preventing mother to child transmission of HIV, it's the same idea except is now being studied in high-risk populations)
PEPFAR - President's Emergency Plan For AIDS Relief (the first wave began under Bush, PEPFAR 2 has just been renewed under Obama - look it up on Wikipedia)
GAP - Global AIDS Program (funded mainly by PEPFAR)
DHAP - Division of HIV/AIDS Prevention (PEPFAR did not allow the funding to go to HIV/AIDS research, leading to a division of program implementation and research. You can come to your own conclusions about the logic behind that.)
TDY - Temporary duty assignment (Yes, I know the letters don't match up. I still don't know why but if you know, please comment.)

These are the ones I have come across this week (that I remember). I'm sure there will be more to add soon.