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首页> 外文期刊>International Journal of Environmental Research and Public Health >Access to HIV Care and Resilience in a Long-Term Conflict Setting: A Qualitative Assessment of the Experiences of Living with Diagnosed HIV in Mogadishu, Somali
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Access to HIV Care and Resilience in a Long-Term Conflict Setting: A Qualitative Assessment of the Experiences of Living with Diagnosed HIV in Mogadishu, Somali

机译：在长期冲突中获得艾滋病毒护理和抗灾力的能力：对索马里摩加迪沙确诊艾滋病病毒感染者生活经验的定性评估

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Background: Human Immunodeficiency Virus (HIV) continues to take a heavy toll on the lives of many people, with the worst impact on health and wellbeing for the affected individuals in fragile states. The HIV situation in Somalia is not clearly known and experiences of the people living with HIV in this war-torn region are often unexpressed. This pilot qualitative study sought to explore the experiences of people diagnosed with HIV living in Mogadishu, and their resilience in access to care and social support. Methods: Participants were recruited through drug dispensers at the HIV clinic in Banadir Hospital. Face-to-face in-depth interviews were conducted in Somali in May 2013 among patients who were receiving antiretroviral therapy (ART) from the HIV clinic in Mogadishu. These were tape-recorded, transcribed, and translated for content analysis. Results: Three women and four men who were living with HIV shared the following narratives. Their perception was that they had either got HIV from their spouses or through health care contamination. They were very knowledgeable about the realities of HIV, how the medication works, nutritional requirements, and drug adherence. They were always willing to go an extra mile to secure a good life for themselves. However, the external HIV stigma impacted their access to care. They faced challenges in their homes and at work which compelled them to seek support from non-governmental organizations (NGOs) or close family members. This stigma often affected their disclosure to the wider community due to the uncertainty of the repercussions, leading to a life of extreme loneliness and financial difficulties. The participants’ coping mechanisms included living together and starting their own NGO for support with very strong optimism about their prognosis. Conclusions: The people diagnosed with HIV living in Mogadishu are highly knowledgeable about HIV transmission, the realities of living with a diagnosed HIV infection, and the efficacy of HIV treatment. Our small sample suggests adequate access to ART through NGOs. However, widespread HIV stigma limits HIV status disclosure to families and communities, which creates a risk of self-isolation and ill health. Still, affected individuals have developed resilient mechanisms for managing the risks. They strive to remain employed for economic security, adhere to HIV treatment, engage in support groups, and maintain the utmost optimism about their prognosis.
机译：背景：人类免疫缺陷病毒（HIV）继续给许多人的生命造成沉重打击，这对脆弱国家的受影响人群的健康和福祉造成的影响最大。尚不清楚索马里的艾滋病毒情况，在这个饱经战祸的地区，艾滋病毒感染者的经历常常没有表现出来。这项初步的定性研究旨在探索摩加迪沙确诊为艾滋病毒感染者的经验，以及他们在获得护理和社会支持方面的弹性。方法：通过Banadir医院HIV诊所的药房招募参与者。 2013年5月，在索马里对从摩加迪沙HIV诊所接受抗逆转录病毒疗法（ART）的患者进行了面对面的深入采访。这些被录音，转录和翻译以进行内容分析。结果：感染艾滋病毒的三名女性和四名男性分享了以下叙述。他们的感觉是他们要么是从配偶那里感染了艾滋病毒，要么是因为医疗保健污染而感染了艾滋病毒。他们非常了解HIV的现状，药物的工作原理，营养需求和药物依从性。他们总是愿意付出更多的努力来确保自己的美好生活。但是，外部艾滋病毒的污名影响了他们获得护理的机会。他们在家庭和工作中面临挑战，迫使他们寻求非政府组织或近亲的支持。由于影响的不确定性，这种污名常常影响他们向更广泛的社区的公开，从而导致极端孤独和经济困难的生活。参与者的应对机制包括共同生活，并建立自己的非政府组织以对他们的预后非常乐观地给予支持。结论：在摩加迪沙居住的被诊断患有HIV的人们对HIV传播，被确诊为HIV感染的现实生活以及HIV的治疗知识非常了解。我们的少量样本表明，可以通过非政府组织充分获得抗逆转录病毒疗法。但是，广泛的艾滋病毒污名将艾滋病毒状况向家庭和社区公开，这会带来自我孤立和健康不良的风险。但是，受影响的个人已经建立了应对风险的弹性机制。他们努力继续为经济安全而工作，坚持接受艾滋病毒治疗，参加支持团体，并对他们的预后保持最大的乐观。

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