Chapter Twelve Increasing the Cost of Living: Class and Exploitation in the Delivery of Social Services to Persons with AIDS

Juliet A. Niehaus

In the human service professions, social services are traditionally cast as the products and activities of the formally organized government or voluntary agencies which function to ameliorate social problems and promote communal well-being ( Weissman 1983:186). Social services include monetary assistance, in-kind aid such as free meals, clothing or housing, 1 and what are often termed "soft services." This final category includes supportive services such as counseling and educational programs. Although the term "social services" primarily refers to governmental or nonprofit assistance, in capitalist economies private sector profit-making agencies may also provide many of these services either independently or under government contracts. Furthermore, inadequacy or unavailability of formal-level services can, as Stack ( 1974) for example has shown, result in the elaboration of "informal" modes of social assistance such as that provided by family and friend support networks. 2

Since the onset of the AIDS epidemic in the early 1980s, services on all three levels--governmental/voluntary, private profit-making, and informal-- have emerged to respond to the complex needs of those who have become ill with the disease. Federal, state, and local programs have aimed to consolidate and prioritize monetary assistance and general support services for persons with AIDS (PWAs). Voluntary nonprofit organizations have developed counseling services, buddy programs, and meal delivery services, and offer legal and financial advocacy and educational information. In the private profit sector, medical home care agencies provide skilled nursing care, intravenous drug infusion supplies and services, and specially trained home health aides to tend to the personal care needs of the ill PWA. When necessary, informal support networks of family and friends supplement, or even at times replace, formal organizations in the provision of both economic and social assistance.

This chapter examines the assistance available to PWAs in New York City

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Culture and AIDS
Table of contents

Table of contents

  • Title Page iii
  • Contents v
  • Preface vii
  • Chapter One - Introduction: Culture and Aids 1
  • Chapter Two - Aids in Cultural, Historic, and Epidemiologic Context 9
  • Notes 23
  • References 24
  • Chapter Three - the Sick Role, Stigma, and Pollution: the Case of Aids 29
  • Notes 42
  • References 43
  • Chapter Four - Assessing Viral, Parasitic, and Sociocultural Cofactors Affecting Hiv-1 Transmission in Rwanda 45
  • Note 51
  • References 51
  • Chapter Five - Aids and the Pathogenesis of Metaphor 55
  • Note 64
  • References 65
  • Chapter Six - Aids and Accusation: Haiti, Haitians, and the Geography of Blame 67
  • Notes 88
  • References 89
  • Chapter Seven - Prostitute Women and the Ideology of Work in London 93
  • Notes 108
  • References 109
  • Chapter Eight Minority Women and Aids: Culture, Race, and Gender 111
  • Notes 128
  • References 131
  • Chapter Nine Language and Aids 137
  • Notes 157
  • References 158
  • Chapter Ten Aids and Obituaries: the Perpetuation of Stigma in the Press 159
  • References 168
  • Chapter Eleven Sex, Politics, and Guilt: A Study of Homophobia and the Aids Phenomenon 169
  • Note 181
  • References 181
  • Chapter Twelve Increasing the Cost of Living: Class and Exploitation in the Delivery of Social Services to Persons with Aids 183
  • Notes 198
  • References 201
  • Chapter Thirteen Postscript: Anthropology and Aids 205
  • Note 208
  • References 208
  • Index 209
  • ABOUT THE EDITOR AND CONTRIBUTORS 215
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