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The work of negotiating HIV as a chronic condition: a qualitative analysis

机译：将艾滋病毒作为慢性病进行谈判的工作：定性分析

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Living with human immunodeficiency virus (HIV) in the industrialised world has for over a decade been conceptualised as living with a chronic illness. People living with HIV now are amongst the first to live and age with the virus. Drawing on a qualitative longitudinal study in a low-incidence area in a low-incidence country, this paper investigates the nuanced ways that people negotiate this condition. While it has been argued that HIV is a condition like any other chronic disease, our thematic analysis reveals some similarities and particularities around living with the condition. In comparing themselves to others with the condition, high levels of diversity of experience were identified that extended well beyond length of time from diagnosis. In comparing their illness with other illnesses, the location, for example, of their specialist service within a clinic for those with acute sexually transmitted diseases was identified as problematic. The work involved in maintaining a coherent sense of self in the face of existing and shifting challenges as a result of their infection was a second strong theme. The final theme involved flux and flex work in the ways people sought to gain and maintain control over various aspects of their lives. All of these experiences are mediated by place; that is the experience is not the same as that of those who live where there is a much higher incidence of infection. The work involved in negotiating this condition in low-incidence environments deserves more attention, but aspects of these findings are significant in higher incidence contexts as well; in particular, passivity in face of infection as one ages and the potential for medication refusal as a means of maintaining control over life and death.
机译：在工业化的世界中，人类免疫缺陷病毒（HIV）生活已被概念化为慢性疾病。现在，艾滋病毒感染者是最早与这种病毒一起生活和衰老的人之一。本文在低发病率国家的低发病率地区进行了定性的纵向研究，研究了人们协商这种情况的细微差别。尽管有人认为艾滋病毒是一种与其他任何慢性病一样的疾病，但我们的主题分析揭示了与该疾病一起生活的某些相似之处和特殊之处。在将自己与其他人进行比较时，发现了丰富的经验，这些经验远远超出了从诊断开始的时间长度。在将他们的疾病与其他疾病进行比较时，例如，将他们在专科诊所内为患有急性性传播疾病的患者所处的位置确定为有问题的。面对因感染而导致的不断变化的挑战，保持连贯的自我意识的工作是第二个重要主题。最后一个主题涉及人们试图获得并保持对生活各个方面的控制的方式中的变动和灵活工作。所有这些经验都是通过地点进行调解的;那就是与那些感染率高得多的人所经历的经历不同。在低发病率环境中谈判这种情况的工作值得更多关注，但是这些发现的某些方面在高发病率环境中也很重要。特别是，随着年龄的增长，面对感染的被动性和拒绝药物治疗的潜力可能成为维持生死控制的一种手段。

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