Kok G
Faculty of Psychology, Maastricht University, P.O. Box 616, 6200 MD Maastricht, Netherlands.
Patient Educ Couns. 1999 Mar;36(3):239-46. doi: 10.1016/s0738-3991(98)00141-4.
People with HIV/AIDS are rarely chosen as a target group for prevention activities. In this paper we look at empirical and theoretical evidence for the feasibility and desirability of directing preventive interventions at HIV-positives. Research data on the behaviour and motivation of HIV-positives suggests that the differences between HIV-positives and HIV-negatives and those who are unaware of their HIV-status are not large. However, specific determinants of behaviour, such as responsibility for others or the risk of superinfection, have seldom been measured. Effective interventions targeting at HIV-positives and focussing on prevention are lacking. Fear of increased stigmatization has been used as an argument against focussing prevention activities at HIV-positives. Theoretically that argument is probably not correct: positive coping with HIV may invite positive reactions. The conclusion is that HIV-positives should be chosen as a special target group for additional planned preventive interventions. Because people need to be aware of their HIV status, testing and treatment sites are adequate settings. Effective interventions should be developed on the basis of theory and evidence about the specific determinants of risk behaviour of HIV-positives: protecting oneself for superinfection and protecting one's partner.
艾滋病毒/艾滋病感染者很少被选为预防活动的目标群体。在本文中，我们探讨了针对艾滋病毒呈阳性者开展预防性干预措施的可行性和可取性的实证及理论依据。关于艾滋病毒呈阳性者行为和动机的研究数据表明，艾滋病毒呈阳性者与艾滋病毒呈阴性者以及那些不知道自己艾滋病毒感染状况的人之间的差异并不大。然而，很少对行为的具体决定因素进行测量，例如对他人的责任或重复感染的风险。缺乏针对艾滋病毒呈阳性者且侧重于预防的有效干预措施。担心污名化加剧被用作反对将预防活动重点放在艾滋病毒呈阳性者身上的理由。从理论上讲，这个理由可能不正确：积极应对艾滋病毒可能会引发积极反应。结论是，应将艾滋病毒呈阳性者选为额外计划预防性干预措施的特殊目标群体。由于人们需要了解自己的艾滋病毒感染状况，检测和治疗场所是合适的环境。应根据关于艾滋病毒呈阳性者风险行为具体决定因素的理论和证据制定有效的干预措施：预防重复感染和保护自己的伴侣。
