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Culturally competent care: a strategic imperative.

Article Excerpt
AIDS continues to be an acute, deadly illness for most of the world s populations. It is the leading killer in the Caribbean, in many countries in Africa, and within the African American population in the United States. Regions in transition are increasingly vulnerable, such as Eastern Europe and Asia. The AIDS virus not only exposes and exploits the human body's vulnerabilities, it likewise exposes the vulnerabilities of our social institutions. Whether in the United States or the Caribbean, HIV/AIDS has demonstrated the dangers of neglected health disparities, barriers to health care, and epidemics of chronic illness. HIV/AIDS has only exacerbated health disparities and compounded the problems of access to care and entrenched chronic illnesses in vulnerable communities. Most critically, the AIDS epidemic completes a spectrum of risk and burden for minority communities, and in the case of Haiti, entire countries, such that members of these communities and societies visibly see the epidemic every day in the very young and in parental figures, layered over other epidemics ranging from malnutrition to cancer. In a sense, it becomes the case that there is no respite or retirement from the epidemic for significant portions of civic society or the global population. This can only become more crucial as progress is made in addressing the "hot spots" of HIV/ AIDS-related mortality, for then the epidemic becomes a chronic burden, in which living with HIV, with aliveness, must become...

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