Reproductive Health and HIV Research Unit, Faculty of Health Sciences, University of Witwatersrand, Hillbrow, South Africa.
Cult Health Sex. 2011 Jan;13(1):31-44. doi: 10.1080/13691058.2010.511270.
Based on qualitative research undertaken during a phase-three microbicide gel trial, this paper explores female participants' experiences and perceptions of gel and condom use and the opinions of their male partners and community members. Participants were aware that condoms were effective in preventing HIV infection and that the efficacy of the microbicide was unproven. Yet, in narratives about gel and condom use, participants ascribed improvements to their reproductive health and intimate relationships with men to gel use. In contrast, condoms were believed to prevent disease, yet also embodied mistrust, were believed to contain dangerous substances and were felt to block the womb. These apparently contradictory views about condoms and gels are explored in the light of conceptions of flow and blockage. Health is achieved by maintaining a steady balance of substances within the body, while preventing fluid flow results in illness. We argue that women enrolled in the trial broadened the meaning of the gel beyond its primary intended effect of preventing HIV. Through their accounts of gel use, women 'reinvented' the gel as a substance that transformed their bodies and sexual relations. This has implications for understanding how local knowledge of health and illness intersects with biomedical knowledge.
基于一项三期杀微生物剂凝胶试验中的定性研究，本文探讨了女性参与者对凝胶和安全套使用的经验和看法，以及她们男性伴侣和社区成员的意见。参与者知道避孕套可以有效预防 HIV 感染，而杀微生物剂的功效尚未得到证实。然而，在关于凝胶和安全套使用的叙述中，参与者将生殖健康的改善和与男性的亲密关系归因于凝胶的使用。相比之下，避孕套被认为可以预防疾病，但也蕴含着不信任，被认为含有危险物质，并且感觉会堵塞子宫。本文在流和阻塞的概念下探讨了对避孕套和凝胶的这些明显矛盾的看法。健康是通过保持体内物质的稳定平衡来实现的，而防止流体流动则会导致疾病。我们认为，参加试验的妇女将凝胶的含义扩大到其预防 HIV 的主要作用之外。通过她们对凝胶使用的描述，妇女将凝胶“重新发明”为一种改变她们身体和性关系的物质。这对于理解当地的健康和疾病知识如何与生物医学知识相交织具有重要意义。
