Multilayered Stigma and Vulnerabilities for HIV Infection and Transmission: A Qualitative Study on Male Sex Workers in Zimbabwe
Multilayered Stigma and Vulnerabilities for HIV Infection and Transmission: A Qualitative Study on Male Sex Workers in Zimbabwe
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DOI：
10.1177/1557988318823883
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发表时间：
2019-01-28
影响因子：
2.3
通讯作者：
Li, Xiaoming
中科院分区：
文献类型：
--
作者：
Tsang, Eileen Yuk-ha;Qiao, Shan;Li, Xiaoming
在大多数社会中，由于卖淫和同性恋之间相互交织的耻辱感，男性性工作者被边缘化。在津巴布韦，据报告，在哈拉雷和布拉瓦约等大城市，男性性工作者激增。然而，缺乏探索他们生活的研究。目前的定性研究的目的是描述性工作的做法，生活环境，艾滋病毒的风险和脆弱性的基础上，在布拉瓦约的15名男性性工作者进行深入访谈。我们的研究表明，对男性性工作者的污名来自不同的部门，包括文化（“同性恋不是非洲人，是白人介绍的”）、宗教（“同性恋在上帝面前是一种罪恶”）、法律和警察（“同性恋在津巴布韦是非法的。从事性工作会使人坐牢”）、媒体（“媒体对性工作者怀有敌意，特别是对男性，因为我们被认为是不正常和不洁的”）和他们的家人（“如果他们知道了，他们会与我断绝关系”）。在这种情况下，男性性工作者被排除在国家艾滋病毒预防和治疗方案之外。他们对艾滋病毒的知识有限，而且有许多误解。来自医疗保健提供者的耻辱和歧视也阻碍了他们寻求健康或艾滋病毒检测。不向女性伴侣透露便利和性关系，进一步增加了她们感染和传播艾滋病毒的脆弱性。目前应对艾滋病毒流行病的努力应关注男性性工作者，并解决相互交织的污名化问题。男性性工作者需要支持和量身定制的艾滋病毒预防和治疗服务，以改善他们的艾滋病毒预防做法、健康和福祉。
Male sex workers are marginalized in most societies due to intersectional stigma between prostitution and homosexuality. In Zimbabwe, a proliferation of male sex workers in major cities such as Harare and Bulawayo has been reported. However, there is a shortage of studies that explore their lives. The current qualitative study aims to describe the practices of sex work, life contexts, and HIV risks and vulnerabilities based on in-depth interviews among 15 male sex workers in Bulawayo. Our studies suggest that the stigma against male sex workers comes from diverse sectors including culture ("homosexuality is un-African, introduced by the Whites"), religion ("same sex is a sin before the God"), law and police ("homosexuality is illegal in Zimbabwe. Engaging in it can send one to prison"), media ("the media is hostile to sex workers particularly men as we are regarded as abnormal and unclean"), and their family ("should they get to know about it, they will disown me"). In this context, male sex workers were excluded from national HIV prevention and treatment programs. They had limited knowledge and many misconceptions about HIV. The stigma and discrimination from health-care providers also discouraged them from health seeking or HIV testing. The non-disclosure to female partners of convenience and sexual relations further increased their vulnerabilities to HIV infection and transmission. Current efforts to address the HIV epidemic should pay attention to male sex workers and tackle the intersecting stigma issues. male sex workers need support and tailored HIV prevention and treatment services to improve their HIV prevention practices, health, and well-being.