The search for social validation and the sexual behavior of people living with HIV in Rio de Janeiro, Brazil: Understanding the role of treatment optimism in context
The search for social validation and the sexual behavior of people living with HIV in Rio de Janeiro, Brazil: Understanding the role of treatment optimism in context
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DOI：
10.1016/j.socscimed.2005.10.037
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发表时间：
2006-05-01
影响因子：
5.4
通讯作者：
Strathdee, Steffanie A.
中科院分区：
文献类型：
--
作者：
Kerrigan, Deanna;Bastos, Francisco I.;Strathdee, Steffanie A.
这项量化研究的主要目的是探索艾滋病毒治疗的乐观态度对在巴西里约热内卢公共卫生诊所接受高效抗逆转录病毒疗法(HAART)的艾滋病毒/艾滋病患者(PLWHA)性行为的影响。我们还探索了参与者性关系的心理-社会动态，以更广泛地了解这些因素如何影响PLWHA的性行为，以及它们如何塑造与HAART相关的信念。对三组人进行了23次半结构化的深入访谈：异性恋女性、异性恋男性和与艾滋病毒携带者发生性关系的男性，这些男性报告去年有性行为活跃，目前正在接受HAART。我们发现，HAART的可用性被概念化为在少数研究参与者中进行不安全性行为的理由，而且这种情况在男性中比在女性中更常见。治疗乐观的具体例子似乎被用作避免承认更深层次的心理社会问题可能一直在影响参与者的性行为的一种手段。大多数参与者的性行为似乎在很大程度上是他们渴望社会认可的产物，并与羞耻感和否认感有关，包括但不限于艾滋病毒。来自这三个群体的参与者都对披露和使用避孕套等行为表示了相当大的恐惧和/或焦虑，因为在他们的性关系背景下，实施这些行为和继续他们的社会确认策略之间存在着未知的冲突。我们的结论是，围绕治疗乐观、披露和避孕套使用的短期信息、教育和沟通干预是适当和必要的；但这些干预措施不足以解决艾滋病患者中不安全性行为的核心挑战。这些根深蒂固的社会心理问题可以通过长期的个人和团体层面的探索和批判性反思机会得到更好的解决，这些机会是关于自我意识及其与妇女解放运动社会团结的关系。(C)2005爱思唯尔有限公司。保留所有权利。
The primary aim of this quantitive study was to explore the influence of HIV treatment optimism on the sexual behavior of people living with HIV/AIDS (PLWHA) receiving highly active anti-retroviral therapy (HAART) at public health clinics in Rio de Janeiro, Brazil. We also explored the psycho-social dynamics of participants' sexual relationships in order to understand more broadly how these factors influence the sexual behavior of PLWHA and how they shape HAART-related beliefs. Twenty-three semi-srtuctured, in-depth interviews were conducted with three groups: heterosexual women, heterosexual men and men who have sex with men living with HIV who reported being sexually active in the last year and were currently receiving HAART. We found that the availability of HAART was conceptualized as it rationale for unsafe sex among a minority of study participants and that this was more common among men than among women. Specific examples of treatment optimism appeared to be employed as a means to avoid acknowledging flow deeper psychosocial issues may have been influencing participant's sexual behavior. Most participants' sexual behavior appeared largely to be a product of their desire for social validation and linked to feelings of shame and denial, including but not limited to HIV. Participants from all three groups expressed a considerable amount of fear and/or anxiety regarding behaviors such as disclosure and condom use as a result of the unexplored conflict between implementing these behaviors and continuing with their strategies for social validation within the context of their sexual relationships. We conclude that short-term information, education and communication interventions Surrounding treatment optimism, disclosure and condom use are appropriate and necessary; but that they arc not sufficient to address the core challenges to unsafe sex among PLHWA. These deep-rooted psychosocial issues may be better addressed by longer-term individual and group-level opportunities for exploration and critical reflection regarding sense of self and its relationship to social solidarity among PLWHA. (c) 2005 Elsevier Ltd. All rights reserved.