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首页> 美国卫生研究院文献>SAHARA J : Journal of Social Aspects of HIV/AIDS Research Alliance >When the clinic becomes a home. Successful VCT and ART services in a stressful environment
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When the clinic becomes a home. Successful VCT and ART services in a stressful environment

机译：当诊所变成家时。在压力环境下成功的VCT和ART服务

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With the upscaling of antiretroviral therapy (ART) in resource-poor countries, many HIV-positive persons in Ghana have been accessing treatment in hospitals. Prevalence is relatively low compared to other African countries, 1.30%. HIV/AIDS remains heavily stigmatised in Ghana, which influences the provision and use of ART. This article investigates how HIV-positive persons accessing care and treatment go about their everyday lives in the ART clinic and how they have eventually come to see the clinic as a safe place that they call ‘home’. The study took place in two Ghanaian hospitals in the Ashanti Region which in 2013 had the country’s highest HIV prevalence rate of 1.30% [Ghana Health Service [GHS]/National AIDS Control Programme [NACP] (2013). 2013 HIV Sentinel Survey Report, Accra, Ghana]. It was conducted through ethnographic research, with data gathered in the two facilities through participant observation, conversations and in-depth interviews. It took place over a period of 15 months, between 2007 and 2010. In all, 24 health workers and 22 clients were interviewed in depth, while informal conversations were held with many others. The findings show that clients have adopted the clinic as a second home and used it to carry out various activities in order to avoid identification and stigmatisation as People Living with AIDS (PLWA). The most dramatic outcome was that, contrary to Ghanaian norms and values, people turned to non-kin for assistance. Accordingly, fellow clients and health personnel, rather than relatives, have become their ‘therapy management group’ [Janzen, J. M. (1987). Therapy Management: Concept, Reality, Process. Medical Anthropology Quarterly, 1(1), 68–84]. The clients have thus created a fictive family within the clinic – made up of health workers (as ‘parents’), the clients themselves (as ‘children’) and the peer educators (as ‘aunts’ and ‘uncles’). In the face of persistent stigma associated with HIV infection in Ghana, the use of the clinic as a ‘home’ has on the one hand helped those receiving treatment to maintain their position, respect and reputation within their families and community, while on the other it prevents PLWA from disclosing. The study concludes that compassion is an important element in the professionalisation of healthcare workers in low-prevalence countries.
机译：随着资源匮乏国家抗逆转录病毒疗法（ART）规模的扩大，加纳许多艾滋病毒呈阳性的人正在医院接受治疗。与其他非洲国家相比，患病率相对较低，为1.30％。在加纳，艾滋病毒/艾滋病仍然受到严重污名化，这影响了抗逆转录病毒疗法的提供和使用。本文研究了接受艾滋病毒和艾滋病治疗的艾滋病毒阳性患者如何在ART诊所中过日常生活，以及他们最终如何将诊所视为他们称为“家”的安全场所。这项研究是在阿散蒂地区的两家加纳医院进行的，该医院在2013年的艾滋病毒感染率是该国最高，为1.30％[加纳卫生服务[GHS] /国家艾滋病控制计划[NACP]（2013）。 2013年艾滋病毒前哨调查报告，加纳，阿克拉]。它是通过人种学研究进行的，通过参与者观察，对话和深入访谈在这两个设施中收集了数据。该活动在2007年至2010年的15个月内进行。总共对24名卫生工作者和22位客户进行了深入访谈，同时与许多其他人进行了非正式对话。调查结果表明，客户已将诊所作为第二故乡，并利用其开展了各种活动，以避免被艾滋病毒携带者（PLWA）识别和污名化。最戏剧性的结果是，与加纳的规范和价值观相反，人们转向非亲属寻求帮助。因此，同伴客户和卫生人员，而不是亲戚，已经成为他们的“治疗管理小组” [Janzen，J. M.（1987）。治疗管理：概念，现实，过程。医学人类学季刊，1（1），68-84]。客户因此在诊所内建立了一个虚构的家庭，该家庭由医护人员（作为“父母”），客户本身（作为“孩子”）和同伴教育者（作为“阿姨”和“叔叔”）组成。面对加纳艾滋病毒感染者的持续污名化，一方面将诊所用作“家”，一方面帮助那些接受治疗的人维持了其在家庭和社区中的地位，尊敬和声誉，另一方面它可以防止PLWA泄露。研究得出结论，同情心是低患病率国家医疗工作者专业化的重要因素。

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