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HIV 血清学不同的夫妇在性关系和生殖决策中的风险协商。

Negotiation of risk in sexual relationships and reproductive decision-making amongst HIV sero-different couples.

机构信息

South Eastern Health and Social Care Trust, Queen's University Belfast, Belfast, Northern Ireland.

出版信息

Cult Health Sex. 2011 Aug;13(7):815-27. doi: 10.1080/13691058.2011.563865. Epub 2011 May 24.

Abstract

The paper focuses on the ways in which medical discourses of HIV transmission risk, personal bodily meanings and reproductive decision-making are re-negotiated within the context of sero-different relationships, in which one partner is known to be HIV-positive. Eighteen in-depth interviews were conducted with 10 individuals in Northern Ireland during 2008-2009. Drawing on an embodied sociological approach, the findings show that physical pleasure, love, commitment, a desire to conceive without medical interventions and a dislike of condoms within regular ongoing relationships, shaped individuals' sense of biological risk. In addition, the subjective logic that a partner had not previously become infected through unprotected sex prior to knowledge of HIV status and the added security of an undetectable viral load significantly impacted upon women's and, especially, men's decisions to have unprotected sex in order to conceive. The findings speak to the importance of reframing public health campaigns and clinical counselling discourses on HIV risk transmission to acknowledge how couples negotiate this risk, alongside pleasure and commitment within ongoing relationships.

摘要

本文聚焦于在一方已知 HIV 阳性的情况下,血清学不同关系背景下,HIV 传播风险、个人身体意义和生殖决策等医学话语是如何被重新协商的。2008 年至 2009 年期间,在北爱尔兰对 10 个人进行了 18 次深入访谈。本研究采用了一种具身社会学方法,研究结果表明,身体愉悦、爱、承诺、在没有医疗干预的情况下怀孕的愿望以及对常规持续关系中使用避孕套的厌恶,塑造了个体对生物风险的感知。此外,在了解 HIV 状况之前,伴侣通过无保护性行为没有感染 HIV 的既往经历,以及无法检测到的病毒载量带来的额外安全性,这极大地影响了女性,尤其是男性决定进行无保护性行为以怀孕的决策。这些发现表明,重新构建关于 HIV 风险传播的公共卫生运动和临床咨询话语非常重要,需要承认伴侣在持续关系中如何协商这种风险,以及其中的愉悦和承诺。

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