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首页> 外文期刊>Culture, Health & Sexuality >The limits of behaviour change theory: Condom use and contexts of HIV risk in the Kolkata sex industry
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The limits of behaviour change theory: Condom use and contexts of HIV risk in the Kolkata sex industry

机译：行为改变理论的局限性：加尔各答性产业中避孕套的使用和艾滋病毒感染的背景

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This paper uses ethnographic data from a sex workers' HIV project in India to consider the appropriateness of individual, social/group and structural theories of health behaviour when applied to HIV-prevention initiatives. Existing theories are critiqued for their modernist representation of behaviour as determined by individual rational decision-making processes or by external structural forces, with inadequate recognition being given to the roles that human agency, subjective meaning and local context play in everyday actions. Analysis of sex workers' accounts of their sexual practices suggests that existing theories of health behaviour can only partially account for sexual behaviour change retrospectively and that they have limited predictive value with respect to the outcomes of individual sexual encounters. Our data show that these outcomes were, in fact, highly context dependent, while possibilities for action were ultimately strongly constrained by structural forces. Findings suggest that interventions need to adopt an integrated, structurally-oriented approach for promoting safer sexual practices in sex work settings. Recognising that no one model of health behaviour is likely to be adequate in explaining or predicting behaviour change encourages responsiveness to local people's agency, recognises the different (health- and non-health-related) registers of risk with which people operate and encourages flexibility according to local contingencies and contexts.
机译：本文使用来自印度性工作者艾滋病项目的人种学数据，考虑将个人，社会/群体和健康行为的结构理论应用于艾滋病预防计划的适当性。对现有理论的批评是对行为的现代主义表现形式的批判，这些表现形式是由个体理性的决策过程或外部结构性力量所决定的，人们对人类代理，主观含义和当地情境在日常行动中所扮演的角色的认识不足。对性工作者关于其性行为的描述的分析表明，现有的健康行为理论只能部分地追溯性行为的变化，并且就个人性遭遇的结果而言，其预测价值有限。我们的数据表明，这些结果实际上高度依赖于上下文，而采取行动的可能性最终受到结构性力量的强烈限制。研究结果表明，干预措施需要采取一种综合的，面向结构的方法，以促进性工作场所的安全性行为。认识到没有任何一种健康行为模型可能足以解释或预测行为变化会鼓励对当地人民机构的反应，认识到人们所从事的不同（健康和非健康相关）风险登记册，并鼓励采取灵活性因地制宜。

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