Antiretroviral therapy and reproductive life projects: mitigating the stigma of AIDS in Nigeria.
Antiretroviral therapy and reproductive life projects: mitigating the stigma of AIDS in Nigeria.
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DOI：
10.1016/j.socscimed.2010.04.006
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发表时间：
2010-07
影响因子：
5.4
通讯作者：
Mbakwem, Benjamin C.
中科院分区：
文献类型：
--
作者：
Smith, Daniel Jordan;Mbakwem, Benjamin C.
由于获得抗逆转录病毒治疗，非洲数以百万计的艾滋病毒感染者越来越能够活得更长、更健康，人们担心，在健康状况改善后，人们可能会避开保护性做法。除了性“去抑制”的概念之外，研究人员已经开始从他们的婚姻和生育愿望的角度分析接受治疗的人的性行为。这篇文章探讨了尼日利亚东南部艾滋病毒阳性男性和女性的生殖生活项目，展示了在患者对婚姻和孩子的社会规范愿望的背景下，违反医疗建议的行为是如何被理解的。根据对参加该地区最古老治疗计划的人的深入采访和观察(2004年6月至12月；2006年6月至7月；2007年6月至7月)，我们认为，艾滋病毒阳性者更敏锐地感受到普遍持有的关于生殖的社会期望。这是因为在尼日利亚，与艾滋病相关的耻辱与社会和道德危机的普遍看法密切相关，因此艾滋病本身被视为产生焦虑的社会变化形式的原因和症状。具体地说，在一个快速社会转型的时代，尼日利亚人将性乱和年轻人对亲属和社区的传统义务疏远，视为社会再生产受到威胁的迹象。对于艾滋病毒阳性的人来说，结婚和生孩子不仅提供了过上正常生活的机会，还提供了一种减轻与该疾病相关的耻辱的手段。提供了四个人种学案例研究，以说明社会和个人生活项目如何以及为什么可以压倒或复杂化医疗和公共卫生优先事项。这些例子表明，如果要实现扩大治疗机会的全部好处，治疗方案必须公开解决并积极支持接受抗逆转录病毒治疗的人的生命项目。
As millions of people infected with HIV in Africa are increasingly able to live longer and healthier lives because of access to antiretroviral therapy, concerns have emerged that people might eschew protective practices after their health improves. Extending beyond the notion of sexual “disinhibition,” researchers have begun to analyze the sexual behavior of people in treatment through the perspective of their marital and childbearing aspirations. This article explores the reproductive life projects of HIV-positive men and women in southeastern Nigeria, showing how actions that contradict medical advice are understandable in the context of patients’ socially normative desires for marriage and children. Based on in-depth interviews and observations (June–December 2004; June–July 2006; June–July 2007) of people enrolled in the region’s oldest treatment program, we argue that broadly held social expectations with regard to reproduction are experienced even more acutely by HIV-positive people. This is because in Nigeria the stigma associated with AIDS is closely tied to widespread perceptions of social and moral crisis, such that AIDS itself is seen as both a cause and a symptom of anxiety-producing forms of social change. Specifically, in an era of rapid societal transformation, Nigerians see sexual promiscuity and the alienation of young people from traditional obligations to kin and community as indicative of threatened social reproduction. For people who are HIV-positive, marrying and having children offer not only the opportunity to lead normal lives, but also a means to mitigate the stigma associated with the disease. Four ethnographic case studies are provided to exemplify how and why social and personal life projects can trump or complicate medical and public health priorities. These examples suggest that treatment programs must openly address and proactively support the life projects of people on antiretroviral therapy if the full benefits of expanded access to treatment are to be realized.
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影响因子：
3.8
作者：
Moatti, JP;Prudhomme, J;Msellati, P
通讯作者：
Msellati, P
影响因子：
0.9
作者：
Rhine, Kathryn A.
通讯作者：
Rhine, Kathryn A.
DOI：
10.2307/3773927
发表时间：
2001-03-01
期刊：
ETHNOLOGY
影响因子：
--
作者：
Smith, DJ
通讯作者：
Smith, DJ
影响因子：
5.4
作者：
Watt, Melissa H.;Maman, Suzanne;Jacobson, Mark
通讯作者：
Jacobson, Mark
DOI：
10.1080/13691050050174468
发表时间：
2000-01-01
期刊：
Culture, Health & Sexuality
影响因子：
--
作者：
Cusick, L.;Rhodes, T.
通讯作者：
Rhodes, T.