multigenerational trauma and hiv in southern africa
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Multigenerational Trauma and HIV in Southern Africa. S. Leclerc-Madlala Office of HIV/AIDS Global Health Bureau USAID AIDS2012, July 22-27, Washington DC. - PowerPoint PPT PresentationTRANSCRIPT
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Multigenerational Trauma and HIV in Southern Africa
S. Leclerc-Madlala Office of HIV/AIDS
Global Health Bureau USAID AIDS2012, July 22-27, Washington DC
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Definition of Multigenerational Trauma: Trauma passed from one generation to the next, either directly or indirectly
One typeHistorical Trauma – A cumulative
emotional and psychological wounding emanating from deliberately perpetrated massive group trauma experience, that becomes culturalized and passed down to successive generations
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Historical Trauma Theory builds upon…Four theoretical frames -• Psychological/psychoanalytic• Political/economic • Social/ecological • Anthropological
Studies of several ‘traumatized’ populations -• 1960s - Holocaust survivors and families • 1980s - American Indian groups (healing ‘soul wounds’)• 1990s - African Americans (Post Traumatic Slavery Syndrome)• More recent - Palestinians, Russians, Cambodians
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Major premise of the theory:
Populations historically subjected to mass trauma - colonialism, slavery, war, genocide, apartheid(?) - are prone to develop maladaptive social, behavioral and dispositional patterns that are transmitted as learned behavior from generation to generation.
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Complex of symptoms:• chronic alcohol use/abuse• distrust of others, including intimates• high levels of violence, GBV, IPV• ‘vacant’ esteem (helplessness, depression,
victimhood)• poor parenting• sense of resignation, fatalism• search for instant gratification, frequent partner
change
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Southern Africa has amongst the world’s highest rates of
• Violence• Sexual abuse/
violation of children• GBV, IPV• Alcohol use/abuse• Youth hopelessness/
suicidal thoughts• Elderly abuse
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Is the region suffering from a form of historical, multigenerational trauma?
Are the resulting behavioral and dispositional patterns catalyzing transmission of HIV and impeding all attempts to address the epidemic?
Yes
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Relevance of the Theory to HIV1. It is a new paradigm that links the past to present &
helps explain high HIV prevalence.
2. It demands social/collective approaches to re-build the capacity of communities to sustain protective practices – collective efficacy or communal healing.
3. It alerts us to the fact that the creation of an ‘AIDS-free generation‘ is a multi-layered social project – breaking the trauma cycle.
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A Theory-in-ProgressValidating construct requires more empirical research
• To identify specific mechanisms of trans-generational transmission (i.e. ‘carrier groups’ and systematic oppression as ‘composite shocks’)
• To link measures of historical mutigenerational trauma to health outcomes
• To investigate mass trauma manifestations in different populations
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Historical Multigenerational Trauma Theory:
A compelling, relevant theoretical framework to help the HIV community
gain a broader and deeper perspective of the disease & conceptualize new
approaches for solutions.
“Medicines can never heal a soul wound”
- Dr. Maria Yellow Horse Braveheart, University of Nevada