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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 >‘If you are found taking medicine you will be called names and considered less of a man’: young men’s engagement with HIV treatment and care during ulwaluko (traditional initiation and circumcision) in the Eastern Cape Province of South Africa
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‘If you are found taking medicine you will be called names and considered less of a man’: young men’s engagement with HIV treatment and care during ulwaluko (traditional initiation and circumcision) in the Eastern Cape Province of South Africa

机译：如果你被发现吃药你将被称为名字并被认为是一个人的名字：年轻人与艾滋病毒治疗和在南非东开普省的乌尔瓦科（传统启动和割礼）期间与艾滋病毒治疗和护理参与

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This paper explores how HIV-positive abakhwetha (young male initiates) undergoing ulwaluko (traditional Xhosa initiation and circumcision) engage with HIV-related biomedical care and treatment. Health-focused life history narratives (n = 36), semi-structured interviews (n = 32) and analysis of health facility files (n = 41) with adolescent boys and young men (ages 13–24) living with HIV, and semi-structured interviews with traditional and biomedical health practitioners (n = 14) were conducted in 2017 and 2018. This research was part of the Mzantsi Wakho study, a longitudinal, mixed methods study of adolescents living with HIV (n = 1060). Findings demonstrate that ulwaluko rules of not engaging with biomedical care and treatment pose a challenge for initiates who are taking chronic medicine. Fears of inadvertent disclosure of their HIV-positive status collide with the pressure to successfully complete ulwaluko in order to be legitimised as men. In response to this dilemma, they engage a variety of strategies – including taking medicine in secret by hiding them, having a trusted person deliver them discretely, and stopping medicine-taking altogether. The three months following ulwaluko also pose a challenge in accessing biomedical treatment and care. In this time of high surveillance, amakrwala (new men) do not present at health facilities for fear of being thought to have had a botched circumcision or to have contravened ‘manhood rules’ and left ulwaluko before having healed properly. To get around this, those who continued taking medicine engaged caregiver pick-ups. Beyond suggesting that ulwaluko is a high-risk time for disengagement from biomedical treatment and care, this paper builds on a robust scholarship on the importance of locality and context in gender and health research. It documents the creativity, agency and resilience of initiates and their families as they subvert and re-signify health-related masculine norms.
机译：本文探讨了艾蒿（传统Xhosa启动和包皮环切）接受艾滋病相关生物医学护理和治疗的艾滋病毒阳性艾滋病毒（年轻男性发起）。以健康的生活历史叙述（n = 36），半结构化访谈（n = 32），以及卫生设施文件（n = 41）的分析与艾滋病毒症和半的青少年男孩（年龄13-24岁） - 2017年和2018年进行了传统和生物医学卫生从业者（N = 14）的结构面试。该研究是Mzantsi Wakho研究的一部分，纵向，混合方法研究与HIV的青少年（n = 1060）。调查结果表明，Ulwaluko没有与生物医学护理和治疗的联系规则对服用慢性医学的初始造成挑战。担心无意中披露其艾滋病毒阳性地位与成功完成乌尔瓦卢的压力碰撞，以便与男性合法化。为了应对这种困境，他们通过隐藏他们的秘密，包括秘密的策略，使受值得信赖的人自由地提供，并完全停止药物。乌尔瓦鲁科三个月也在进入生物医疗和护理方面构成了挑战。在这个高监视的时候，Amakrwala（新男性）不存在于卫生设施，因为害怕被认为有拙劣的割礼或违反“女性规则”并在妥善愈合之前离开了Ulwaluko。为了解决这个问题，那些继续吃药的护理人员拾取。除了表明Ulwaluko是从生物医学治疗和护理脱离的高风险时间，这篇论文是一项稳健的奖学金，奖学金关于地方和健康研究中的地方和背景的重要性。它根据他们颠覆和重新签订了与健康相关的男性化规范，记录了发起人，代理和家庭的创造力，代理和恢复力。

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