In malaria-endemic countries about a quarter of test-negative individuals take antimalarials (artemisinin-based combination therapies, ACTs). ACT overuse depletes scarce resources for subsidies and contributes to parasite resistance. As part of an experiment in Kenya that provided subsidies for rapid diagnostic test and/or for ACT conditionally on being positive, we study the relationship between beliefs on malaria status (prior and posterior the intervention), and the decisions to get tested and to purchase ACT. We find that prior beliefs do not explain the decision of getting tested (conditional on the price) and non-adherence to a negative test. However, test-negative individuals who purchase ACT report higher posterior beliefs than those who do not, consistent with a framework in which the formers revise beliefs upward, while the latters do not change or revise downward. Further research is needed to improve adherence to malaria-negative test results.
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Pub Date : 2010-05-28DOI: 10.4337/9781849805162.00063
M. Gutmann
In contemporary Mexico, AIDS is a disease of migration and modernity. Worldwide AIDS is often argued to be a direct product of neo-liberal policies that have prompted the decentralization and privatization of healthcare. At the same time, structural adjustments related to these changes in healthcare which have been imposed by international agencies like the World Bank have fostered conditions in which populations are forced to flee their homelands in search of better economic prospects in other countries. This is clearly the case in Mexico, where local impoverished circumstances lead millions to try their luck on the other side of the border in the United States (U.S.). In the southern Mexican state of Oaxaca, for instance, where detailed ethnographic fieldwork over several years provides the basis of this chapter, to be a migrant means that you are poor and likely to be from one of the area’s many indigenous groups. Extrapolating from notoriously unreliable government statistics, by 2000 there were probably over 100,000 men and women from Oaxaca working as migrants in northern parts of Mexico and the United States. It was also estimated by this time that 60 per cent of Oaxaca’s municipios (municipalities) had experienced significant emigration. Leading on from the above, the political economy of AIDS in Oaxaca involves several features which are also global in scope, with transnational migration being key: the largest demographic group in the state who are HIV-positive are poor Indian men who have worked in the United States and returned to Oaxaca infected with the virus. The second largest demographic group who are HIV-positive are women who have had sex with these migrant men. Since the late 1990s, in a process called ‘medical profiling’, migrant men and their sexual partners have become slotted into the public health category of ‘dangerous citizens’, capable of infecting the better-off sectors of Oaxacan society.
{"title":"New Labyrinths of Solitude: Lonesome Mexican Migrant Men and Aids","authors":"M. Gutmann","doi":"10.4337/9781849805162.00063","DOIUrl":"https://doi.org/10.4337/9781849805162.00063","url":null,"abstract":"In contemporary Mexico, AIDS is a disease of migration and modernity. Worldwide AIDS is often argued to be a direct product of neo-liberal policies that have prompted the decentralization and privatization of healthcare. At the same time, structural adjustments related to these changes in healthcare which have been imposed by international agencies like the World Bank have fostered conditions in which populations are forced to flee their homelands in search of better economic prospects in other countries. This is clearly the case in Mexico, where local impoverished circumstances lead millions to try their luck on the other side of the border in the United States (U.S.). In the southern Mexican state of Oaxaca, for instance, where detailed ethnographic fieldwork over several years provides the basis of this chapter, to be a migrant means that you are poor and likely to be from one of the area’s many indigenous groups. Extrapolating from notoriously unreliable government statistics, by 2000 there were probably over 100,000 men and women from Oaxaca working as migrants in northern parts of Mexico and the United States. It was also estimated by this time that 60 per cent of Oaxaca’s municipios (municipalities) had experienced significant emigration. Leading on from the above, the political economy of AIDS in Oaxaca involves several features which are also global in scope, with transnational migration being key: the largest demographic group in the state who are HIV-positive are poor Indian men who have worked in the United States and returned to Oaxaca infected with the virus. The second largest demographic group who are HIV-positive are women who have had sex with these migrant men. Since the late 1990s, in a process called ‘medical profiling’, migrant men and their sexual partners have become slotted into the public health category of ‘dangerous citizens’, capable of infecting the better-off sectors of Oaxacan society.","PeriodicalId":118640,"journal":{"name":"AARN: Illness Case Studies (Sub-Topic)","volume":"235 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2010-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131702163","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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