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首页> 外文期刊>AIDS care. >'You should be grateful to have medicines': continued dependence, altering stigma and the HIV treatment experience in Serbia.
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'You should be grateful to have medicines': continued dependence, altering stigma and the HIV treatment experience in Serbia.

机译：“您应该感谢您服用药物”：持续的依赖，改变的耻辱感和塞尔维亚的HIV治疗经验。

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The expectation that universal HIV treatment access in resource-stretched settings will reduce stigma is a powerful aspiration that has been incorporated into a global rhetoric of hope around the HIV pandemic. Between 2005 and 2007, we undertook qualitative longitudinal research with people living with HIV/AIDS (PLHIV) in Serbia. We draw here upon the thematic analysis of prospective interview accounts of 20 individuals to analyse PLHIV's perceptions of the influence of HIV treatment upon their quality of life. HIV is one of few conditions in Serbia where its treatment is fully funded by the state. Inconsistent treatment delivery means HIV treatment is experienced as insecure. Competitive claims for stretched national resources interplay with a moral economy which sees PLHIV as "undeserving" citizens. The guilt and anxiety felt by PLHIV intersect with severely curtailed employment opportunities, which weaken the anticipated restorative and empowering properties embedded within the promise of universal HIV treatment access. Rationed expectations of patient or system instigated change mean PLHIV's efforts are orientated towards short-term individualised self-care, drawing on bureaucratic technologies to mediate their uncertainty. These factors integrate to create a specific cultural and historical context for an altered but continuing stigma towards PLHIV in this era of treatment. This case study cautions against neglecting the underlying structural process of stigmatisation that constrains the capacity of PLHIV to participate in anti-stigma and community organising activities, indicating that in this setting HIV treatment is insufficient alone to reduce stigma or enable major social and economic change in the everyday lives of PLHIV.
机译：期望在资源紧张的环境中普及艾滋病毒治疗将减少污名化，这是一项强有力的愿望，已被纳入围绕艾滋病毒大流行的全球希望之言中。在2005年至2007年之间，我们对塞尔维亚的HIV / AIDS感染者（PLHIV）进行了定性的纵向研究。我们在此基于对20位个体的前瞻性访谈账户的主题分析，以分析PLHIV对HIV治疗对其生活质量的影响的看法。艾滋病毒是塞尔维亚为数不多的由国家完全资助治疗的疾病之一。不一致的治疗手段意味着艾滋病毒治疗经验不安全。竞争激烈的国家资源主张与道德经济相互影响，道德经济将艾滋病毒感染者视为“无益的”公民。 PLHIV感到的内和焦虑与严重减少的就业机会相交，这削弱了普及HIV治疗的希望中蕴含的预期的恢复性和赋权性。对患者或系统引发变化的合理期望意味着，艾滋病毒/艾滋病感染者的工作主要针对短期个性化自我保健，依靠官僚技术来调解其不确定性。这些因素融合在一起，创造了一种特定的文化和历史背景，在这种治疗时代，人们对​​艾滋病毒感染者的看法有所改变，但仍在继续。本案例研究告诫不要忽视污名化的基本结构过程，该过程限制了PLHIV参与反耻辱和社区组织活动的能力，这表明在这种情况下，仅靠HIV治疗不足以减少污名化或促进重大的社会和经济变革艾滋病毒感染者的日常生活。

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