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越南社区中与艾滋病相关耻辱感的观点:一项定性研究。

Perspectives of HIV-related stigma in a community in Vietnam: a qualitative study.

机构信息

School of Nursing, Memorial University of Newfoundland, St. John's, NL, Canada.

出版信息

Int J Nurs Stud. 2010 Jan;47(1):38-48. doi: 10.1016/j.ijnurstu.2009.06.004. Epub 2009 Sep 2.

Abstract

BACKGROUND

While HIV/AIDS is increasing in Vietnam, very few published studies focus on HIV-related stigma in Vietnam. This study reports on findings from a community development project to reduce HIV-related stigma within one community in Vietnam.

OBJECTIVES AND DESIGN

The purpose of this qualitative study is to describe HIV-related stigma from the perspective of three groups within one community in Vietnam: people living with HIV, their family members, and community members and leaders, including health care professionals. SETTING, PARTICIPANTS AND METHODS: Fifty-eight individuals from a poor, industrial district on the outskirts of a large city participated in the study and were asked to describe HIV-related stigma. Interviews were conducted with 10 people living with HIV, 10 family members of a person living with HIV, and 10 community members and 5 community leaders including health care professionals. We also conducted three focus groups, one with people living with HIV (n=8), one with family members of people living with HIV (n=8), and one with community leaders including health care professionals (n=7).

FINDINGS

Stigma across the three groups is characterized by four dimensions of HIV-related stigma: feeling shamed and scorned, behaving differently, stigma due to association, and fear of transmission. The manifestation of these dimensions differs for each group. Four themes of HIV-related stigma as described by people living with HIV are: being avoided, experiencing anger and rejection, being viewed as a social ill, and hiding the illness. Seven themes of HIV-related stigma as described by family members are: shunned by neighbors, viewed as poor parents, discriminated by health professionals, overhearing discussions about people with HIV, maintaining the secret, financial hardship for family, and fear of contracting HIV. Four themes of HIV-related stigma as described by community members and leaders including health professionals are: stigma as a fair reward, avoidance and shunning by neighbors, ruined family reputation, and fear of contracting HIV.

CONCLUSIONS

HIV-related stigma is experienced in a different manner by each of these groups, a finding that should help in developing culturally sensitive strategies to reduce HIV-related stigma in Vietnam.

摘要

背景

尽管越南的艾滋病毒/艾滋病感染人数不断增加,但很少有已发表的研究关注越南的艾滋病毒相关耻辱问题。本研究报告了在越南一个社区开展的减少艾滋病毒相关耻辱的社区发展项目的结果。

目的和设计

本定性研究的目的是从越南一个社区的三个群体的角度描述艾滋病毒相关耻辱问题:艾滋病毒感染者、他们的家庭成员以及社区成员和领导人,包括医疗保健专业人员。

地点、参与者和方法:来自一个大城市郊区贫困工业区的 58 人参与了这项研究,并被要求描述艾滋病毒相关耻辱。对 10 名艾滋病毒感染者、10 名艾滋病毒感染者的家庭成员以及 10 名社区成员和 5 名社区领导(包括医疗保健专业人员)进行了访谈。我们还进行了三个焦点小组,一个是艾滋病毒感染者(n=8),一个是艾滋病毒感染者的家庭成员(n=8),一个是社区领导(包括医疗保健专业人员)(n=7)。

结果

这三个群体的耻辱感具有艾滋病毒相关耻辱的四个维度:感到羞耻和被轻视、行为不同、因关联而受到歧视以及对传播的恐惧。这些维度的表现因群体而异。艾滋病毒感染者所描述的艾滋病毒相关耻辱的四个主题是:被回避、遭受愤怒和拒绝、被视为社会弊病以及隐瞒病情。家庭成员所描述的艾滋病毒相关耻辱的七个主题是:被邻居回避、被视为贫穷的父母、被医疗保健专业人员歧视、无意中听到有关艾滋病毒感染者的讨论、保守秘密、家庭经济困难以及害怕感染艾滋病毒。社区成员和领导人(包括医疗保健专业人员)所描述的艾滋病毒相关耻辱的四个主题是:耻辱是公平的惩罚、邻居回避和回避、家庭声誉受损以及害怕感染艾滋病毒。

结论

这些群体中的每一个群体都以不同的方式体验艾滋病毒相关耻辱,这一发现有助于制定在越南减少艾滋病毒相关耻辱的文化敏感策略。

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