ABC for people with HIV: responses to sexual behaviour recommendations among people receiving antiretroviral therapy in Jinja, Uganda
ABC for people with HIV: responses to sexual behaviour recommendations among people receiving antiretroviral therapy in Jinja, Uganda
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DOI：
10.1080/13691058.2011.558593
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发表时间：
2011-01-01
影响因子：
2.2
通讯作者：
Jaffar, Shabbar
中科院分区：
文献类型：
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作者：
Allen, Caroline;Mbonye, Martin;Jaffar, Shabbar
正在接受抗逆转录病毒疗法(ART)的艾滋病毒携带者越来越多地参与到“积极预防”行动中。这些措施通常旨在促进节欲、“忠诚”(减少伴侣)和使用避孕套(ABC)。我们对使用抗逆转录病毒疗法的艾滋病毒携带者进行了一项纵向定性研究，乌干达非政府组织艾滋病支持组织(TASO)为他们提供了坚持教育和咨询支持。40人在开始抗逆转录病毒治疗时依次被选中，按性别、抗逆转录病毒治疗的分娩方式(诊所或家庭)和艾滋病毒进展阶段(早期或晚期)进行分层，并在登记时以及3、6、18和30个月时进行访谈。在ART开始时，参与者同意遵循Taso的积极生活建议。起初，健康状况不佳阻碍了性行为。随着健康状况的改善，参与者优先考虑恢复经济生产和对子女的支持。随着进一步的改善，性欲重新浮出水面，恋爱中的人通过性行为巩固了这些性欲。调查结果突出了以医疗保健/个人咨询为基础的艾滋病毒预防的局限性。随着艺术带来健康改善，社会规范、经济需求和性欲越来越多地影响着性行为。积极的预防干预措施需要设法改变对性行为的规范和经济影响，并提供避孕套的替代品。
People living with HIV who are taking antiretroviral therapy (ART) are increasingly involved in 'positive prevention' initiatives. These are generally oriented to promoting abstinence, 'being faithful' (partner reduction) and condom use (ABC). We conducted a longitudinal qualitative study with people living with HIV using ART, who were provided with adherence education and counselling support by a Ugandan non-governmental organisation, The AIDS Support Organisation (TASO). Forty people were selected sequentially as they started ART, stratified by sex, ART delivery mode (clinic- or home-based) and HIV progression stage (early or advanced) and interviewed at enrolment and at 3, 6, 18 and 30 months. At initiation of ART, participants agreed to follow TASO's positive-living recommendations. Initially poor health prevented sexual activity. As health improved, participants prioritised resuming economic production and support for their children. With further improvements, sexual desire resurfaced and people in relationships cemented these via sex. The findings highlight the limitations of HIV prevention based on medical care/personal counselling. As ART leads to health improvements, social norms, economic needs and sexual desires increasingly influence sexual behaviour. Positive prevention interventions need to seek to modify normative and economic influences on sexual behaviour, as well as to provide alternatives to condoms.