"No one can ask me 'Why do you take that stuff?'": men's experiences of antiretroviral treatment in South Africa
"No one can ask me 'Why do you take that stuff?'": men's experiences of antiretroviral treatment in South Africa
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DOI：
10.1080/09540120903111536
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发表时间：
2010-01-01
影响因子：
1.7
通讯作者：
Hosegood, Victoria
中科院分区：
文献类型：
--
作者：
Fitzgerald, Molly;Collumbien, Martine;Hosegood, Victoria
本文探讨了性别塑造的健康行为，卫生保健的经验和艾滋病毒阳性男性在南非开始抗逆转录病毒治疗的叙述。我们进行了参与者观察和深入的，半结构化的访谈，在夸祖鲁-纳塔尔的一个农村卫生区的公共艾滋病毒治疗计划注册的8名男子。我们还采访了他们的家人和项目工作人员。研究发现，男性对抗逆转录病毒治疗（ART）的叙述和经历是复杂的。控制和应对的描述与低自尊和内疚并列。治疗后健康状况的改善增加了对未来的乐观情绪，但由于男子担心无法满足与家庭和工作有关的强烈性别期望，这种乐观情绪很容易受到破坏。研究发现，男性自己或家庭成员使用和滥用酒精是影响披露、摄取和遵守的一个重要问题。鉴于在治疗期间不鼓励饮酒的信息，男子报告说，他们在试图停止或减少饮酒时，自我推迟了登记，尽管没有人在这样做时寻求咨询或专业帮助。男性还感到家庭成员酗酒对他们的威胁很大，因为他们担心意外暴露、侮辱和暴力。关于保健提供者，男子强烈认为方案工作人员的行为应适当和专业，特别是在保密方面。随着非洲抗逆转录病毒疗法项目的建立和发展，我们不仅需要确定男性获得和坚持治疗的障碍，还需要监测他们的健康和治疗经历。这些发现表明，酒精和ART问题值得进一步调查。对初级保健提供者和咨询人员进行关于促进男子健康的额外培训可能是有益的。
This paper examines the way gender shaped the health behaviours, health care experiences and narratives of HIV-positive men initiating antiretroviral treatment in South Africa. We conducted participant observation and in-depth, semi-structured interviews with eight men enrolled in a public HIV treatment programme in a rural health district in KwaZulu-Natal. We also interviewed their family members and programme staff. The study found that men's narratives and experiences of antiretroviral therapy (ART) were complex. Descriptions of control and coping juxtaposed with low self-esteem and guilt. Improvements in health following treatment increased optimism about the future but were readily undermined by men's concerns about being unable to meet strongly gendered expectations in relation to family and work. Alcohol use and abuse by men themselves or by family members was found to be an important issue influencing disclosure, uptake and adherence. Given messages discouraging alcohol use during treatment, men reported self-imposed delays to enrolment while they tried to stop or reduce alcohol use, although none had sought advice or professional help in doing so. Men also felt very threatened by alcohol abuse by family members fearing accidental disclose, insults and violence. With regards to health providers, men held strong views as to appropriate and professional behaviour by programme staff, particularly regarding confidentiality. As ART programmes in Africa become established and evolve, we not only need to identify barriers to men's access and adherence but monitor their health and treatment experiences. These findings suggest that the issue of alcohol and ART warrants further investigation. Additional training for primary health care providers and counsellors on health promotion with men may be useful.