Ambivalent tales of HIV disclosure in San Francisco
Ambivalent tales of HIV disclosure in San Francisco
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DOI：
10.1016/j.socscimed.2003.08.026
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发表时间：
2004-06-01
影响因子：
5.4
通讯作者：
Crosby, GM
中科院分区：
文献类型：
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作者：
Sheon, N;Crosby, GM
鉴于旧金山男男性行为者 (MSM) 中无保护肛交 (UAI) 水平不断上升，我们试图了解披露做法、风险计算以及对 HIV 血清转化的态度。 2000 年，150 名 MSM 参加了 m 次采访，采访内容围绕最近发生的一起 UAI 事件进行了详细叙述。为了了解个人和社区规范之间的关系，我们分析了受访者对艾滋病毒流行和旧金山同性恋社区的经历中的叙述。为了证明他们危险的性行为是合理的，MSM 引用了自高活性抗逆转录病毒疗法 (HAART) 出现以来，社区范围内向保密和无鞍的转变。由于担心艾滋病毒呈阳性的伴侣拒绝使用安全套，艾滋病毒呈阴性的男性认为向他们认为绝大多数艾滋病毒呈阳性的临时伴侣透露信息没有什么好处。相比之下，艾滋病毒呈阳性的男性似乎渴望披露自己的阳性状况，以摆脱传播的责任，并促进“无鞍”或无保护的性行为。尊重社区规范而否认个人对安全性行为的责任可能会导致近期危险行为和艾滋病毒发病率的急剧上升。讨论了预防政策的影响。 (C) 2003 Elsevier Ltd. 保留所有权利。
In light of rising levels of unprotected anal intercourse (UAI) among men who have sex with men (MSM) in San Francisco, we sought to understand disclosure practices, the calculus of risk and attitudes about HIV seroconversion. In 2000, 150 MSM participated m interviews pivoting around a detailed narrative of a recent incident of UAI. In order to understand the relationship between individual and community norms, we analyzed the narratives as accounts situated within the respondents' experience of the HIV epidemic and the gay community in San Francisco. In justifying their risky sexual practices, MSM cited a community-wide shift toward non-disclosure and barebacking since the advent of highly active anti-retroviral therapy (HAART). Fearing rejection by HIV-positive partners who refuse to use condoms, HIV-negative men saw little advantage in disclosing to casual partners whom they perceived as overwhelmingly HIVpositive. By contrast, HIV-positive men appeared eager to disclose their positive status to release themselves from responsibility for transmission and facilitate "bareback" or unprotected sex. Disavowal of individual responsibility for safer sex in deference to community norms may contribute to the recent spiraling of risk behavior and HIV incidence. Implications for prevention policy are discussed. (C) 2003 Elsevier Ltd. All rights reserved.