Life projects and therapeutic itineraries: marriage, fertility, and antiretroviral therapy in Nigeria
Life projects and therapeutic itineraries: marriage, fertility, and antiretroviral therapy in Nigeria
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DOI：
10.1097/01.aids.0000298101.56614.af
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发表时间：
2007-10-01
期刊：
影响因子：
3.8
通讯作者：
Mbakwem, Benjamin C.
中科院分区：
文献类型：
--
作者：
Smith, Daniel Jordan;Mbakwem, Benjamin C.
目的：为了检查和了解婚姻和生育的愿望和行为的个人接受抗逆转录病毒疗法（ART）在尼日利亚和评估的影响对性行为，披露，和adherence.Design and Methods：本研究采用人种学方法的参与者观察和深入访谈的个人接受抗逆转录病毒疗法通过政府支持的计划在东南部尼日利亚。对接受治疗的个人的访谈和观察表明，婚姻和生育是通过抗逆转录病毒疗法恢复健康的人的最高愿望。引入生活项目的概念，并将其与治疗路线的既定理念相结合，以显示如何参与和坚持治疗，披露艾滋病毒状况，关于性行为的决定不能用纯粹的生物医学术语来理解。婚姻和生育愿望通常会影响并经常超越临床和公共卫生优先事项。象征性的案例研究，以说明激励和解释的行为似乎不利于个人和公共health.Conclusion：有效的抗逆转录病毒治疗方案的设计和管理将需要承认，往往使而不是劝阻个人的婚姻和生殖目标，如果披露，坚持和预防的问题要切实解决的社会动态。(c)2007年威科健康|利平科特威廉姆斯&威尔金斯。
Objective: To examine and understand the marital and fertility aspirations and behaviours of individuals receiving antiretroviral therapy (ART) in Nigeria and evaluate the effects on sexual behaviour, disclosure, and adherence.Design and methods: The study used ethnographic methods of participant observation and in-depth interviews of individuals receiving ART through a government-supported programme in southeastern Nigeria.Results: Interviews and observations of individuals on treatment demonstrate that marriage and childbearing are paramount desires for people whose health is restored by ART. The concept of life projects is introduced and combined with the established idea of therapeutic itineraries to show how participation in and adherence to treatment, disclosure of HIV status, and decisions about sexual behaviour cannot be understood in purely biomedical terms. Marital and reproductive aspirations routinely impinge on and often trump clinical and public health priorities. Emblematic case studies are provided to illustrate the social dynamics that motivate and explain behaviour seemingly inimical to individual and public health.Conclusion: Effective antiretroviral programme design and therapy management will require acknowledging and often enabling rather than discouraging the marital and reproductive goals of individuals if issues of disclosure, adherence, and prevention are to be realistically addressed. (c) 2007 Wolters Kluwer Health | Lippincott Williams & Wilkins.