Structural and symbolic violence within the Irish healthcare system: the case of HIV in Ireland

The term structural violence has been employed by researchers in the field of medical anthropology to describe the sociocultural, economic and infrastructural barriers that negatively affect the health outcomes of individuals, groups and society. Farmer (2006) describes how structural violence is often embedded longstanding ubiquitous social structures, normalized by stable institutions and regular experience (p.1686). Structural violence is, in large part, underpinned by symbolic violence, whereby discursive constructions of reality act to reproduce and reinforce asymmetric relations of power, reflecting wider patterns of social inequality so as to appear natural or given (Bourdieu, 1991). This paper seeks to explore these ideas with reference to HIV care, prevention and management in Ireland, examining how cultural, institutional and social factors have negatively impacted upon the HIV response in this country and, in the context of unprecedented rising rates of infection, discuss how the legacy of shame and stigma continues to influence the epidemic today.