...
  • 主题
高级搜索  >
历史搜索 清空历史
首页> 外文期刊>American journal of public health >“We, the AIDS people. . .”: How Antiretroviral Therapy Enables Zimbabweans Living With HIV/AIDS to Cope With Stigma
【24h】

“We, the AIDS people. . .”: How Antiretroviral Therapy Enables Zimbabweans Living With HIV/AIDS to Cope With Stigma

机译：“我们，艾滋病人。 。 ”：抗逆转录病毒疗法如何使患有艾滋病毒/艾滋病的津巴布韦人能够应对耻辱感

获取原文
           
页面导航
  • 摘要
  • 著录项
  • 相似文献
  • 相关主题

摘要

We studied the impact of antiretroviral treatment availability on HIV/AIDS stigma through interviews with 118 antiretroviral treatment users, HIV/AIDS caregivers, and nurses in Zimbabwe. Treatment enables positive social and economic participation through which users can begin to reconstruct their shattered sense of social value. However, stigma remains strong, and antiretroviral treatment users remain mired in conflictual symbolic relationships between the HIV/AIDS people and the untested. To date, the restoration of users' own sense of self-worth through treatment has not reduced fear and sexual embarrassment in framing community responses to people living with HIV/AIDS. Much remains to be learned about the complex interaction of economic and psychosocial dimensions of poverty, treatment availability, and conservative sexual moralities in driving HIV/AIDS stigma in specific settings. How does antiretroviral treatment (ART) affect the ability of ART users to cope with HIV/AIDS stigma? Stigma is a key driver of the HIV/AIDS epidemic, particularly in low-income settings. 1 , 2 Psychologists have dominated discussions of its causes, foregrounding individual-level explanations, which include unrealistic fears of contagion and social embarrassment of the sexual nature of HIV transmission. 3 The greatest challenge to this dominance comes from Castro and Farmer. In their classic 2005 article, they argue that stigma is determined more by lack of effective health services and treatment than by psychological factors, particularly in resource-poor settings where the sick and dying drain scarce community resources. 4 They argue that access to ART enables people living with HIV/AIDS to regain potential value as economically and socially competent citizens and that as ART becomes universally accessible, stigma will gradually disappear. Since this 2005 article, ART has been slowly rolled out, 5 transforming HIV/AIDS from a tortuous death sentence to a manageable chronic illness and providing researchers an opportunity to explore Castro and Farmer's arguments in specific contexts. We investigated the impact of ART on users in rural Zimbabwe to explore how treatment availability affects stigma in this setting. Goffman emphasizes the need to use the “language of social relationships rather than the language of attributes” 6 to understand stigma. Viewing stigma as negative social representations of HIV-infected people, we examined the processes through which people living with HIV/AIDS internalize or resist it, leading to positive or negative social identities. We understand social identity in terms of Cooley's notion of the looking glass self 7 and Mead's observation that social identities are heavily determined by how others view us. 8 A vital precondition for human well-being and agency is the recognition of people as having value by those around them. 9 Stigma arises when people are denied such recognition. We examine the extent to which the availability of ART opens up new modes of positive social recognition for treatment users. At the time of our late 2009 study 34% (2010 WHO guidelines) of those needing antiretroviral drugs in Zimbabwe were receiving them (compared with an average of 37% across sub-Saharan Africa). 5 , 10 Many people living with HIV/AIDS remain visibly ill and dying, health services battle with the complex demands of ART rollout, and the long-term future of heavily donor-sponsored ART services remains uncertain. Although it is too early to offer definitive comment on Castro and Farmer's claims at this early stage, our study provides useful preliminary insights into potential pathways between ART use and stigma.
机译：我们通过与津巴布韦的118名抗逆转录病毒治疗使用者，HIV / AIDS护理人员和护士进行访谈，研究了抗逆转录病毒治疗的可获得性对HIV / AIDS耻辱的影响。通过治疗，积极的社会和经济参与将使用户开始重建其破碎的社会价值感。但是，耻辱感仍然很强，抗逆转录病毒治疗的使用者仍然沉迷于艾滋病毒/艾滋病患者与未经测试者之间的冲突性象征关系。迄今为止，通过制定治疗手段恢复使用者自身的自我价值感，并没有减少社区对艾滋病毒/艾滋病感染者的反应时的恐惧感和性尴尬。在特定环境中，艾滋病毒/艾滋病的耻辱感在贫困中的经济和社会心理层面，治疗的可获得性和保守的性道德的复杂相互作用尚有待研究。抗逆转录病毒疗法（ART）如何影响ART使用者应对HIV / AIDS污名的能力？耻辱感是艾滋病毒/艾滋病流行的主要驱动力，尤其是在低收入环境中。 1，2 心理学家主导了对这种病因的讨论，提出了个人层面的解释，包括对传染病和传染病的不切实际的恐惧。艾滋病毒传播的性行为引起的社会尴尬。 3 这种优势的最大挑战来自卡斯特罗和法默。他们在其2005年的经典文章中认为，耻辱更多是由缺乏有效的医疗服务和治疗所决定，而不是由心理因素所决定，尤其是在资源匮乏的地区，那里生病和垂死的人耗尽了稀缺的社区资源。 4 他们认为，获得抗逆转录病毒疗法可使艾滋病毒/艾滋病感染者重新获得具有经济和社会能力的公民的潜在价值，而且随着抗逆转录病毒疗法的普遍普及，污名将逐渐消失。自2005年这篇文章以来，ART一直在缓慢地推出， 5 将艾滋病毒/艾滋病从曲折的死刑转变为可控制的慢性病，​​并为研究人员提供了在特定情况下探索卡斯特罗和法默论点的机会。我们调查了抗逆转录病毒疗法对津巴布韦农村地区使用者的影响，以探讨在这种情况下治疗的可获得性如何影响耻辱感。高夫曼强调需要使用“社会关系的语言而不是属性的语言” 6 来理解污名。我们认为污名是艾滋病毒感染者的消极社会代表，我们研究了艾滋病毒/艾滋病感染者内部化或抵抗它的过程，从而导致了正面或负面的社会认同。我们根据库利的镜面自我 7 和米德（Mead）的观察来理解社会身份，社会地位在很大程度上取决于他人如何看待我们。 8 9 当人们被剥夺了对他人的认可时，就会产生污名。我们研究了抗逆转录病毒疗法在多大程度上为治疗使用者开创了积极的社会认可的新模式。在我们2009年末的研究之时，津巴布韦有34％（2010年WHO指南）需要抗逆转录病毒药物的人正在接受这些药物（撒哈拉以南非洲地区的平均水平为37％）。 5，10 许多艾滋病毒/艾滋病感染者仍然生病和垂死，医疗服务面临着抗逆转录病毒疗法推广的复杂需求，并且由捐助者大力赞助抗逆转录病毒疗法服务的长期前景仍然不确定。尽管在早期阶段就Castro和Farmer的主张提供明确的评论还为时过早，但我们的研究为了解ART使用和耻辱之间的潜在途径提供了有用的初步见解。

著录项

相似文献

  • 外文文献
  • 中文文献
  • 专利
获取原文

客服邮箱：kefu@zhangqiaokeyan.com

京公网安备：11010802029741号 ICP备案号：京ICP备15016152号-6 六维联合信息科技 (北京) 有限公司©版权所有

  • 客服微信

  • 服务号