Antiretroviral therapy and changing patterns of HIV stigmatisation in Entebbe, Uganda.
Antiretroviral therapy and changing patterns of HIV stigmatisation in Entebbe, Uganda.
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DOI：
10.1111/1467-9566.12341
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发表时间：
2016-01
影响因子：
2.9
通讯作者：
Seeley J
中科院分区：
文献类型：
--
作者：
Russell S;Zalwango F;Namukwaya S;Katongole J;Muhumuza R;Nalugya R;Seeley J
抗逆转录病毒疗法(ART)有可能改变艾滋病毒污名化的过程。在这篇文章中，分析了乌干达瓦基索地区一群艾滋病病毒携带者(PLWH)对抗逆转录病毒治疗的污名化的变化过程，使用了一项关于PLWH对艾滋病病毒自我管理的研究的定性数据。有38名受访者(20名女性，18名男性)服用抗逆转录病毒药物至少1年。他们是从政府和非政府的艺术提供者中刻意挑选出来的。对每位参与者进行了两次深入访谈。由于他们外表的恢复和卫生工作者的支持，明显减少了自我羞辱的过程。然而，大多数参与者继续隐瞒自己的身份，因为他们预计会受到耻辱；例如，他们害怕八卦、拒绝和他们的身份被用来攻击他们。预期的耻辱是性别上的：女性对被伴侣拒绝等成文形式的耻辱表现出更大的恐惧；相比之下，男性的恐惧集中在八卦、丧失尊严和自我羞辱上。证据表明，抗逆转录病毒疗法并没有减少污名化的根本结构性驱动因素，特别是性别认同和不平等，仍然需要干预措施来减轻和解决污名化问题，例如咨询、同行领导的教育和支助团体，以帮助妇女和儿童重建替代的和更积极的身份。本文的视频摘要可在以下网址找到：https://youtu.be/WtIaZJQ3Y_8
Antiretroviral therapy (ART) has the potential to change processes of HIV stigmatisation. In this article, changing processes of stigmatisation among a group of people living with HIV (PLWH) on ART in Wakiso District, Uganda, are analysed using qualitative data from a study of PLWH's self‐management of HIV on ART. There were 38 respondents (20 women, 18 men) who had been taking ART for at least 1 year. They were purposefully selected from government and non‐government ART providers. Two in‐depth interviews were held with each participant. Processes of reduced self‐stigmatisation were clearly evident, caused by the recovery of their physical appearance and support from health workers. However most participants continued to conceal their status because they anticipated stigma; for example, they feared gossip, rejection and their status being used against them. Anticipated stigma was gendered: women expressed greater fear of enacted forms of stigma such as rejection by their partner; in contrast men's fears focused on gossip, loss of dignity and self‐stigmatisation. The evidence indicates that ART has not reduced underlying structural drivers of stigmatisation, notably gender identities and inequalities, and that interventions are still required to mitigate and tackle stigmatisation, such as counselling, peer‐led education and support groups that can help PLWH reconstruct alternative and more positive identities. A video abstract of this article can be found at: https://youtu.be/WtIaZJQ3Y_8