Chomat Anne Marie Belz, Wilson Ira B, Wanke Christine A, Selvakumar A, John K R, Isaac Rita
Department of Geographic Medicine and Infectious Diseases, Tufts Medical Center, Nutrition/Infection Unit, Boston, Massachusetts 02111, USA.
AIDS Patient Care STDS. 2009 Jun;23(6):477-84. doi: 10.1089/apc.2008.0222.
In India, little is known about health care-seeking behavior among HIV-infected individuals. Similarly, little is known about how HIV is being treated in the community, in particular by Indian Systems of Medicine (ISM) providers. Therefore, while ART implementation programs continue to expand, it is important to determine whether the knowledge, attitudes, and treatment practices of HIV-infected individuals and their health care providers are aligned with current treatment recommendations. We conducted in-depth qualitative interviews with persons with HIV (n = 9 men and 17 women), family members of persons with HIV (n = 14 men and 3 women), and ISM providers (n = 7). Many of the patients we studied turned at some point to ISM providers because they believed that such practitioners offer a cure for HIV. ISM treatments sometimes had negative impacts including side effects, unchecked progression of an underlying illness, and financial depletion. Indian women tended to be less knowledgeable about HIV and HIV treatments, and had less access to financial and other resources, than men. Finally, most of the ISM providers reported dangerous misconceptions about HIV transmission, diagnosis, and treatment. While the existence of ART in India is potentially of great benefit to those with HIV infection, this study shows that a variety of social, cultural and governmental barriers may interfere with the effective use of these therapies. Partnerships between the allopathic and traditional/complementary health sectors in research, policy, and practice are essential in building comprehensive HIV/AIDS treatment strategies.
在印度，人们对艾滋病毒感染者寻求医疗保健的行为知之甚少。同样，对于社区中如何治疗艾滋病毒，尤其是印度医学体系（ISM）的提供者如何治疗艾滋病毒，也了解甚少。因此，尽管抗逆转录病毒治疗（ART）实施项目在不断扩大，但确定艾滋病毒感染者及其医疗保健提供者的知识、态度和治疗实践是否与当前的治疗建议相一致非常重要。我们对艾滋病毒感染者（9名男性和17名女性）、艾滋病毒感染者的家庭成员（14名男性和3名女性）以及ISM提供者（7名）进行了深入的定性访谈。我们研究的许多患者在某个时候求助于ISM提供者，因为他们认为这些从业者能治愈艾滋病毒。ISM治疗有时会产生负面影响，包括副作用、基础疾病的未加控制的进展以及经济耗尽。与男性相比，印度女性对艾滋病毒和艾滋病毒治疗的了解往往较少，获得资金和其他资源的机会也较少。最后，大多数ISM提供者报告了对艾滋病毒传播、诊断和治疗的危险误解。虽然印度存在ART可能对艾滋病毒感染者有很大益处，但这项研究表明，各种社会、文化和政府障碍可能会干扰这些疗法的有效使用。在研究、政策和实践中，对抗疗法与传统/补充卫生部门之间的伙伴关系对于构建全面的艾滋病毒/艾滋病治疗策略至关重要。
