Anderson Moji, Elam Gillian, Gerver Sarah, Solarin Ijeoma, Fenton Kevin, Easterbrook Philippa
University of the West Indies, Kingston, Jamaica.
Soc Sci Med. 2008 Sep;67(5):790-8. doi: 10.1016/j.socscimed.2008.05.003. Epub 2008 Jun 18.
This paper explores the effects of HIV/AIDS-related stigma and discrimination (HASD) on HIV-positive Caribbean people in the Caribbean and the UK. In-depth, semi-structured interviews were held with a purposively selected group of 25 HIV-positive people of Caribbean origin, using primary selection criteria of sex, age, sexuality and country of birth. Interviews with respondents revealed that they are keenly aware of the stigma surrounding HIV/AIDS, which some attribute to a particularly Caribbean combination of fear of contamination, homophobia, and ignorance, reinforced by religious beliefs. In fact, religion serves a double role: underpinning stigma and assisting in coping with HIV. HASD has usually occurred where respondents have lost or do not have control over disclosure. Compared to UK-born respondents, the accounts of Caribbean-born respondents, most of whom were born in Jamaica, include more reports of severe HASD, particularly violence and employment discrimination. All respondents mobilise a variety of strategies in order to avoid HASD, which have implications for their social interactions and emotional well being. While some manage to avoid the "spoiled identity" of the stigmatised, thereby creating their own understandings of HIV infection, these may remain individual-level negotiations. HASD affects HIV-positive Caribbean people at home and in the diaspora in a variety of ways: emotionally, mentally, financially, socially and physically. Interventions specifically addressing stigma and discrimination must be formulated for the UK's Caribbean population. Tackling stigma and discrimination requires more than education; it requires "cultural work" to address deeply entrenched notions of sexuality.
本文探讨了与艾滋病毒/艾滋病相关的耻辱感和歧视（HASD）对加勒比地区以及英国的加勒比裔艾滋病毒呈阳性者的影响。我们对25名有目的地挑选出来的加勒比裔艾滋病毒呈阳性者进行了深入的半结构化访谈，主要挑选标准包括性别、年龄、性取向和出生地。对受访者的访谈显示，他们敏锐地意识到围绕艾滋病毒/艾滋病的耻辱感，有些人将其归因于加勒比地区特有的对感染的恐惧、恐同心理和无知的结合，并因宗教信仰而加剧。事实上，宗教起到了双重作用：强化耻辱感并帮助应对艾滋病毒。HASD通常发生在受访者失去或无法控制披露信息的情况下。与在英国出生的受访者相比，出生在加勒比地区（其中大多数出生在牙买加）的受访者讲述了更多严重的HASD案例，特别是暴力和就业歧视。所有受访者都采取了各种策略来避免HASD，这对他们的社交互动和情感幸福产生了影响。虽然有些人设法避免了被污名化的“受损身份”，从而形成了他们自己对艾滋病毒感染的理解，但这些可能仍然只是个人层面的应对。HASD在情感、心理、经济、社会和身体等方面以多种方式影响着加勒比地区以及海外侨民中的艾滋病毒呈阳性者。必须为英国的加勒比人群制定专门针对耻辱感和歧视的干预措施。应对耻辱感和歧视不仅仅需要教育；还需要开展“文化工作”来解决根深蒂固的性观念问题。
