Masculinity as a barrier to men's use of HIV services in Zimbabwe.
Masculinity as a barrier to men's use of HIV services in Zimbabwe.
复制标题
DOI：
10.1186/1744-8603-7-13
复制
发表时间：
2011-05-15
影响因子：
10.8
通讯作者：
Gregson S
中科院分区：
文献类型：
--
作者：
Skovdal M;Campbell C;Madanhire C;Mupambireyi Z;Nyamukapa C;Gregson S
越来越多的研究突显出男性不愿使用艾滋病毒服务。这表明，有一些因素阻碍了男性参与卫生服务，迫切需要解开决定男性接受或拒绝艾滋病毒服务的社交形式。根据53名抗逆转录病毒药物使用者和25名医疗保健提供者的观点，我们定性地检查了津巴布韦农村地区男子气概的当地结构如何影响男性对艾滋病毒服务的使用。举报人报告了一种明确和霸道的男子气概概念，要求男子控制并采取行动、拥有专门知识、强壮、有韧性、无疾病、高度性行为和经济生产力。然而，这些特质与好病人的形象直接冲突，好病人被期望接受艾滋病毒阳性，听从护士的指示，并从事有利于健康的行为，如定期去医院就诊，戒酒和无保护的婚外性行为。当地人对男子气概的理解与生物政治学上对“好病人”的描述之间的冲突，可以为津巴布韦为什么有这么多男性不使用艾滋病毒服务提供可能的解释。然而，一旦男性接受了咨询，并有机会反思艺术对他们生产力和社会价值的影响，一些人就有可能构建新的、更适合艺术的男性气概版本。我们敦促艾滋病毒服务提供者考虑阻碍许多男性获得其服务的障碍，并主张以社区为基础和推动的举措，为男性提供安全和支持性的社交空间，以公开讨论男子气概的社会结构，并重新谈判更多有利于健康的男性气概。
A growing number of studies highlight men's disinclination to make use of HIV services. This suggests there are factors that prevent men from engaging with health services and an urgent need to unpack the forms of sociality that determine men's acceptance or rejection of HIV services. Drawing on the perspectives of 53 antiretroviral drug users and 25 healthcare providers, we examine qualitatively how local constructions of masculinity in rural Zimbabwe impact on men's use of HIV services. Informants reported a clear and hegemonic notion of masculinity that required men to be and act in control, to have know-how, be strong, resilient, disease free, highly sexual and economically productive. However, such traits were in direct conflict with the 'good patient' persona who is expected to accept being HIV positive, take instructions from nurses and engage in health-enabling behaviours such as attending regular hospital visits and refraining from alcohol and unprotected extra-marital sex. This conflict between local understandings of manhood and biopolitical representations of 'a good patient' can provide a possible explanation to why so many men do not make use of HIV services in Zimbabwe. However, once men had been counselled and had the opportunity to reflect upon the impact of ART on their productivity and social value, it was possible for some to construct new and more ART-friendly versions of masculinity. We urge HIV service providers to consider the obstacles that prevent many men from accessing their services and argue for community-based and driven initiatives that facilitate safe and supportive social spaces for men to openly discuss social constructions of masculinity as well as renegotiate more health-enabling masculinities.