integrity of the victims’ next of kin has been violated based on the additional suffering they have experienced as a result of the specific circumstances of the violations perpetrated against their loved ones, and owing to the subsequent acts or omissions of the State authorities in relation to the facts, 223 taking into account, among other matters, the steps taken to obtain justice and the existence of close family ties. 224 It has also declared the violation of this right based on the suffering resulting from the acts perpetrated against their loved ones.225 Furthermore, the Court has indicated that the State’s contribution to creating or aggravating the situation of vulnerability of a person has a significant impact on the integrity of those around them, especially the close family members who are faced with the uncertainty and insecurity arising from the violation of the rights of their direct or close family member.226 192. In this regard, the Court notes that the evidence reveals that the physical and psychological suffering experienced by the presumed victims in this case owing to the absence of medical treatment also affected some of their family members, and this was aggravated by the stigmatization suffered by the next of kin of people living with HIV. Specifically, the Court notes that the next of kin have experienced pain, anguish and uncertainty owing to the lack of opportune medical care, especially the lack of access to drugs, as well as frustration and helplessness because they did not have the financial resources to provide their next of kin with the needed treatment.227 Also, some of them have witnessed the deterioration in the health of their loved ones, and some of them have even had to confront the death of some of them.228 193. The Court also observes that the lack of medical care also affected the family dynamics of the victims, because some of their family members were obliged to change their working hours,229 abandon or suspend their studies and/or migrate to the United 223 Cf. Case of Blake v. Guatemala. Merits. Judgment of January 24, 1998. Series C No. 36, para. 114, and Case of Herzog et al. v. Brazil. Preliminary objections, merits, reparations and costs. Judgment of March 15, 2018. Series C No. 353, para. 351. Cf. Case of Blake v. Guatemala. Merits. Judgment of January 24, 1998. Series C No. 36, para. 114, and Case of Poblete Vilches et al. v. Chile. Merits, reparations and costs. Judgment of March 8, 2018. Series C No. 349, para. 208. 224 Cf. Case of Bámaca Velásquez v. Guatemala. Merits. Judgment of November 25, 2000. Series C No. 70, paras. 162 and 163, and Case of Poblete Vilches et al. v. Chile. Merits, reparations and costs. Judgment of March 8, 2018. Series C No. 349, para. 208. 225 Cf. Case of the Yean and Bosico Girls v. Dominican Republic. Judgment of September 8, 2005. Series C No. 130, para. 205, and Case of Poblete Vilches et al. v. Chile. Merits, reparations and costs. Judgment of March 8, 2018. Series C No. 349, para. 205. 226 María de Jesús Chajón de León, Carlos Fernando Coc Chajón, Cruz García Ramos, Luis Alberto Hernández Estrada, Estuardo Edison Hernández Estrada, Osma Vinicio Hernández Estrada, Karen Herlinda Hernández Estrada, Miriam Lisbeth Hernández Estrada and María Magdalena Rodas Mérida, Victoria Ramírez Ramos, Sandra Judith Pérez Cayaxon, Guadalupe Pérez Cayaxon, Yensi Nohemi Pérez Cayaxon, Braulio Adán Rodas Mérida, Andy Alberto Rodas Mérida, Anibal Leonel Rodas Mérida, Clara Veronica Rodas Mérida, Sonia Maribel Rodas Mérida, Walter Audencio Rodas Mérida, Flor de María Rodas Mérida and Leonel Celestino Mazariegos Cinto. 227 María Elena Morales Villafuerte, Brandon David Adalberto Gómez Morales, María de Jesús Chacón de León, Carlos Fernando Coc Chajón, Antonio Vail Molina, Lexana Rosbetty Pérez Vail, Cruz García Ramos, Sandra Judith Pérez Cayaxon, Guadalupe Pérez Cayaxon, Yensi Nohemí Pérez Cayaxon, Luis Alberto Hernández Estrada, Estuardo Edison Hernández Estrada, Osma Vinicio Hernández Estrada, Karen Herlinda Hernández Estrada and Miriam Lisbeth Hernández Estrada, Leonel Celestino Mazariegos Cinto, Antonio Miranda Méndez and Victoria Ramírez Ramos. 228 Aníbal Leonel Rodas Mérida, Clara Verónica Rodas Mérida, Sonia Maribel Rodas Mérida, Braulio Adán Rodas Mérida, Andy Alberto Rodas Mérida, Walter Audencio Rodas Mérida, Flor de María Rodas Mérida and María Magdalena Rodas Mérida. 229 66