Trust and HIV/AIDS Trust is the expectation that arises within a community of regular, honest and cooperative

behavior, based on commonly shared norms, on the part of other members of that community. Those norms can be about deep ‘value’ questions like the nature of God or justice, but they also encompass secular norms like professional standards and codes of behavior.’ (see Fukuyama, Trust: The Social Virtues and the Creation of Prosperity, 1996: 26). Fukuyama sees trust as ‘a stable cultural factor’ which, in my opinion, disregards processes of interaction and negotiation between actors. • In the mainstream Western-oriented trust theories, there is distinction between trust and confidence. Confidence is generally accepted by social scientists as certainty that existing arrangement or system will produce the predicted outcome, whereas trust is seen as one of the effective means of protecting the self against the unknown. (see Luhmann, Trust and Power, 1979). Confidence situations apply when social system can be relied upon to deliver certain outcomes while trust situations involve choices with uncertain or unpredictable outcomes. The construction of the Other is the basis of the concept of trust in mainstream trust theory, which includes assessment of sincerity, competence and reliability (see Yamazaki, In search of social infrastructure for the Twenty-first century, 1997). For example, in the article ‘When Silence = Death….” ‘patients’ are constructed as naïve, medically illiterate, desperate victims, vulnerable to ‘marketing’; while ‘pharmaceutical companies’ are constructed as opportunistic, profit-seeking private entities who are skilled ‘marketers’. (p. 295).

In structural terms, trust generally relies on some kind of regulatory or enforcement mechanism in the form of rules, laws, sanctions, gossip, shame and other forms of punishment or threat of punishment. In the article of Maguire et.al the identity of ‘patient’ is rejected by PWAs due to the notions of passive, ignorant, victim and suffering. The identity of PWAs is more powerful because it has notions of empowered, informed and organized decision makers. In Indonesia, PWAs translated into ODHA and it also carries such notions particularly among AIDS activists. But health services/providers still perceive them as ‘patient’ with stigmatized disease that makes ODHA has lack of trust to health providers, particularly in public health services. Most ODHA are more comfortable with – and trust on -- health service initiated by NGOs or public health service that collaborate with NGOs.

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