Doubting the existence of AIDS: a barrier to voluntary HIV testing and counselling in urban Mali
Doubting the existence of AIDS: a barrier to voluntary HIV testing and counselling in urban Mali
复制标题
DOI：
10.1093/heapol/czg019
复制
发表时间：
2003-06-01
影响因子：
3.2
通讯作者：
Castle, S
中科院分区：
文献类型：
--
作者：
Castle, S
在马里的锡卡索和巴马科两个城市进行了定性研究，以建立艾滋病毒自愿检测和咨询服务，并制定一项单独的方案，使年轻人能够改善其性健康。最引人注目的发现是，许多受访者表示他们不相信艾滋病的存在。不相信的原因是，人们认为中国没有艾滋病病例，病毒不可能通过蚊子传播，以及对母婴传播的认识不清。受过高等教育的人非常怀疑这种疾病的存在，认为这是西方国家鼓励使用避孕套以阻止非洲人口增长的阴谋。那些更有可能相信这种疾病存在的人是教育程度较低或没有受过教育的人，他们亲眼见过艾滋病患者，而且往往是作为劳工移徙到艾滋病毒流行率较高的科特迪瓦。答复者认为，这种怀疑态度可能会限制自愿咨询和检测服务的使用。可能不使用服务的其他原因包括，有些人对实验室技术人员的能力缺乏信心，担心检测呈阳性的人会受到社区的高度指责。因此，在建立任何中心之前，需要开展广泛的提高认识运动。需要开展预防性教育方案，在其他健康风险的背景下应对艾滋病毒。这将使人们能够以互动的方式影响关于艾滋病毒/艾滋病的辩论，使之适合自己的需要。目前，通过媒体或卫生教育工作者向他们单向提供有关这种疾病的信息，这似乎助长了他们的怀疑态度。
Qualitative research was carried out in the Malian cities of Sikasso and Bamako with a view to setting up HIV voluntary testing and counselling (VCT) services and a separate programme to enable young people to improve their sexual health. The most striking finding was that a large number of respondents said they did not believe in the existence of AIDS. Reasons for disbelief were related to the perceived lack of AIDS cases in China, the inability of the virus to be transmitted by mosquitoes and confusion about mother-to-child transmission. Highly educated individuals were very sceptical of the existence of the illness, thinking it to be a Western plot to encourage condom use in order to halt the growth of the African population. Those who were more likely to believe in the existence of the illness were less educated or uneducated people who had personally seen someone sick with AIDS, often when they had been on labour migration to Cote d'Ivoire where HIV prevalence is higher. Respondents thought it likely that this scepticism will limit the use of VCT services. Other reasons for the potential non-use of services included the fact that some people lacked confidence in the competence of the laboratory technicians and were afraid that those testing positive would be highly stigmatized by the community. Thus, widespread awareness-raising campaigns are needed before any centres can be set up. Participatory education programmes are required to address HIV in the context of other health risks. This would allow people to inter-actively shape the debate about HIV/AIDS to fit their own needs. Currently, they are presented with information about the illness in a unidirectional manner via the media or health educators which seems to fuel their scepticism.