Department of Sociomedical Sciences, Mailman School of Public Health, Columbia University, United States.
Soc Sci Med. 2014 Jan;100:38-45. doi: 10.1016/j.socscimed.2013.10.021. Epub 2013 Oct 31.
This paper discusses labor migration as an example of how focusing on the meso-level highlights the social processes through which structural factors produce HIV risk. Situating that argument in relation to existing work on economic organization and HIV risk as well as research on labor migration and HIV vulnerabilities, the paper demonstrates how analyzing the processes through which labor migration creates vulnerability can shift attention away from the proximate behavioral determinants of HIV risk and toward the community and policy levels. Further, it presents the concepts of externalities and the ethics of consumption, which underline how both producers and consumers benefit from low-waged migrant labor, and thus are responsible for the externalization of HIV risk characteristic of supply chains that rely on migrant labor. These concepts point to strategies through which researchers and advocates could press the public and private sectors to improve the conditions in which migrants live and work, with implications for HIV as well as other health outcomes.
本文以劳动力迁移为例，探讨了关注中层层面如何突出结构因素产生 HIV 风险的社会过程。本文将这一论点置于与经济组织和 HIV 风险相关的现有研究以及劳动力迁移和 HIV 脆弱性研究的关系中，展示了分析劳动力迁移如何造成脆弱性的过程，可以将注意力从 HIV 风险的直接行为决定因素转移到社区和政策层面。此外，本文还提出了外部性和消费伦理的概念，这些概念强调了生产者和消费者如何从低薪移民劳动力中受益，因此对依赖移民劳动力的供应链将 HIV 风险外化的特征负有责任。这些概念指明了研究人员和倡导者可以通过哪些策略向公共和私营部门施压，以改善移民的生活和工作条件，这对 HIV 以及其他健康结果都有影响。
