By Gary Jones
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Additional info for HIV and Young People: Risk and Resilience in the Urban Slum
From research conducted in different cities around the world, it appears that private pharmacies and, to a lesser extent, private clinics are often the predominant form of health care for slum inhabitants (Khan et al. 2012). These establishments are often managed by poorly qualified or inexperienced health-care providers offering unregulated services (Khan et al. 2012). As Unger and Riley (2007) state, in the private sector, fees and costs are always involved and at all stages of health care, which, for those living in extreme poverty, can seem prohibitive or be simply out of reach.
24 2 Vulnerability and Risk: Health and Wellbeing in the Slum medication. With high levels of stigma and discrimination, a strict confidentiality is often the only resource in treatment adherence and integration into the local community (AIDSinfo 2014). However, the need to ‘keep secret’ an HIV-positive status and treatment regimen can also lead to feelings of shame and resentment, which, in turn, militate against the principle of SMART practice as it may lead to situations in which treatment adherence becomes untenable.
Living every day in a world of violence and intimidation with constant noise, pollution, poor housing and overcrowding and in conditions of abject poverty and especially for migrant communities cultural dislocation can prove overwhelming. These conditions give way to feelings of depression, anxiety, fear and violence inwardly and outwardly directed (Turan and Besirli 2008). Sexual and Reproductive Health in Urban Africa Seeing the structural inequities at the core of poor health outcomes, some modest improvement in reproductive health policies and service delivery has been noted in sub-Saharan Africa (UNFPA 2014).