Tarakeshwar Nalini, Srikrishnan A K, Johnson Sethulakshmi, Vasu C, Solomon Suniti, Merson Michael, Sikkema Kathleen
Department of Psychiatry, Yale University School of Medicine, The Consultation Center, 389 Whitney Avenue, New Haven, CT 06511, USA.
AIDS Behav. 2007 May;11(3):491-504. doi: 10.1007/s10461-006-9161-z.
In-depth interviews were conducted with 50 HIV-positive adults (23 women, 27 men) with access to care at a non-governmental organization in Chennai, India to gain a broad understanding of how they managed their HIV infection. Using a Social Cognitive Model of Health, we identified factors within the model's three domains--Personal, Environmental, and Behavioral--that are applicable to this socio-cultural context. The Personal domain's factors were a positive self-concept, family-focused goals, and treatment optimism; the Environmental domain comprised family-based support, treatment availability, access and quality, and HIV stigma and discrimination; and the Behavior domain's factors were medication adherence and health habits, sexual behavior, and social relationships and emotional well-being. Significant differences for many of the factors within the three domains were observed across married men and women, widowed women, unmarried men, and female sex workers. Implications for an enhanced intervention for HIV-infected individuals in similar treatment settings are discussed.
在印度金奈的一个非政府组织，对50名能够获得治疗的HIV阳性成年人（23名女性，27名男性）进行了深入访谈，以全面了解他们如何管理自己的HIV感染情况。运用健康社会认知模型，我们在该模型的三个领域——个人、环境和行为——中确定了适用于这种社会文化背景的因素。个人领域的因素包括积极的自我概念、以家庭为中心的目标和治疗乐观态度；环境领域包括家庭支持、治疗可及性、可及性和质量以及HIV污名和歧视；行为领域的因素包括药物依从性和健康习惯、性行为以及社会关系和情绪健康。在已婚男性和女性、丧偶女性、未婚男性以及女性性工作者中，观察到三个领域内许多因素存在显著差异。讨论了在类似治疗环境中对HIV感染者加强干预的意义。
