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Facing the Plagues Alone. Men Reshaping the HIV and Heroin Epidemics in Colombia

Ruiz-Sánchez, Héctor-Camilo (2021) Facing the Plagues Alone. Men Reshaping the HIV and Heroin Epidemics in Colombia. Doctoral Dissertation, University of Pittsburgh. (Unpublished)

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In my PhD dissertation, I show that HIV-positive heterosexual men and heroin users are often forced to bear the intensity of HIV and opioid addiction, respectively, in silence and without institutionalized care. I argue that the absence of support for these groups and the political blindness towards the suffering of these invisible populations makes their chronic diseases fatal.

I show that Colombian HIV prevention and treatment policies, known for their inclusiveness of diverse gender dynamics, have systematically excluded heterosexual men from prevention and healthcare, most profoundly impacting men living in poverty. I examine how heterosexual men find out about their HIV diagnosis, how they understand it, and how they cope with it. I highlight the struggles that heterosexual men must undergo to access support and medical networks, as well as the complicated role of HIV in romantic and family relationships. I also show how the neoliberal fragmentation and privatization of the Colombian healthcare system, as well as the centralization of HIV clinics in cities, magnifies the negative experiences of men living in poverty in urban and rural areas of Colombia.

My dissertation also explores the effects of the rapidly growing heroin epidemic in Colombia, a “risk group” for HIV and Hepatitis C infection, through the experiences, photographs, and narratives of heroin users in the first state-run methadone clinic in the southwest of Colombia. I explain how inter-American shifts in the legal and illegal opioid markets have resulted in the production and marketing of heroin within Colombia, sparking an unprecedented national epidemic with nearly non-existent public policies to deal with the issue.

Moreover, my research shows that HIV and heroin addiction can sometimes can become experiences of self-reflection that promote positive changes. These reflections with positive outcomes are typically the product of the labor of men in conjunction with partners, family members, friends and idealistic institutions. The dissertation concludes with a discussion on family formation and legal opioids as technologies of hope that give meaning to the lives of men and women I talked to.


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Item Type: University of Pittsburgh ETD
Status: Unpublished
CreatorsEmailPitt UsernameORCID
Ruiz-Sánchez, Héctor-Camilohcr7@pitt.eduhcr70000-0002-0353-007X
ETD Committee:
TitleMemberEmail AddressPitt UsernameORCID
Committee ChairMusante, Kathleen
Committee MemberDocumet, Patricia
Committee MemberAlter, Joseph
Committee MemberReeser, Todd
Date: 3 May 2021
Date Type: Publication
Defense Date: 16 November 2020
Approval Date: 3 May 2021
Submission Date: 29 March 2021
Access Restriction: No restriction; Release the ETD for access worldwide immediately.
Number of Pages: 272
Institution: University of Pittsburgh
Schools and Programs: Dietrich School of Arts and Sciences > Anthropology
Degree: PhD - Doctor of Philosophy
Thesis Type: Doctoral Dissertation
Refereed: Yes
Uncontrolled Keywords: HIV/AIDS, opioids addiction, Colombia, heterosexual men, CBPR.
Date Deposited: 03 May 2021 14:37
Last Modified: 11 Jun 2021 18:17

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