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Weston, H.J. (2003). Public honour, private shame and HIV: issues affecting sexual health service delivery in London's South Asian communities. Health & Place, 9(2), 109-117.
- This paper considers how socio-cultural factors affect HIV and sexual health services among South Asians in London and demonstrates the complexities of providing culturally sensitive sexual health services for the community.
- South Asian countries, such as India, Pakistan and Bangladesh, currently have one of the fastest growing rates of HIV infections in the world. The 2.7% of the British population who are of South Asian origin maintain strong social, familial and business links with the South Asian region. Of AIDS cases among Asian individuals living in the UK, 41% result from “exposure abroad,” demonstrating a strong need to provide sexual health services to this underrepresented community.
- Low levels of HIV testing in the South Asian community can be attributed to denial about HIV, along with low rates of utilization of medical screening services.
- Within South Asian communities, there is a strong emphasis on protecting the public honor (“izzat”) of one’s family and community. As long as stigmatized behaviors like pre-marital sex and drug use are hidden from the public, they will not bring shame (“sharam”) and can be tolerated. This socially constructed public-private idea holds many implications for HIV services for South Asians in London. It is essential for HIV/AIDS service organizations to be aware of an individual’s public identity (their visible behavior) and their private behavior when developing culturally appropriate interventions.
- Recommendations for culturally appropriate methods that can address HIV/AIDS in the South Asian community include:
- Educational materials in South Asian languages
- Information about HIV/AIDS and condoms disseminated in private settings, such as public toilet cubicles and drop in spaces
- Clear explanation of confidentiality with regards to HIV status
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