Department of Sociology and Anthropology, Baruch College, The City University of New York, New York, NY, USA.
Glob Public Health. 2011;6 Suppl 2:S174-91. doi: 10.1080/17441692.2011.581675. Epub 2011 Jul 6.
The purpose of this study is to explore the concept of religious health assets (RHA) and its relevance to HIV/AIDS. This manuscript describes the experiences of caregivers with a church-run home-based care organisation in Swaziland, site of the world's highest HIV prevalence (42%). In light of reduced antiretroviral treatment rollout in some areas of Africa, strengthening mechanisms of treatment support with HIV prevention has never been more critical. One modality may be community home-based care (CHBC), a core feature of the World Bank's Multi-Country HIV/AIDS Program for Africa. Yet, these entities, and the frontline activities of local congregations, remain underexplored. Part of a larger anthropological study of religion and HIV/AIDS in Swaziland, this manuscript draws on 20 semi-structured caregiver interviews to discern patterns in motivations; perceived client needs; care practices; and meanings of religiosity. Thirteen participants were care coordinators who oversaw approximately 455 caregivers across nearly half of the 22 communities served. Grounded theory analysis suggested that caregivers facilitated vital decisions around HIV testing, HIV disclosure, treatment uptake/adherence, as well as reduced HIV stigma. Also salient was the importance of a Christian ethos, in the form of 'talk' and 'love', as critical culturally situated care practices. Having expanded to an estimated 600 caregivers and 2500 home-based clients between 2006 and 2009, Participants' reports intimated their roles as agents of broader social transformation. This article contributes to the expanding study of RHA and challenges authoritative global public health strategies that have largely marginalised local religious aspects of HIV/AIDS. Future applied research examining how 'home' and 'church' may be vital public health settings outside of, but integral to, formal health services and HIV programming is warranted.
本研究旨在探讨宗教健康资产（RHA）的概念及其与艾滋病病毒/艾滋病的相关性。本文描述了斯威士兰一个教会运营的家庭护理组织的护理人员的经验，斯威士兰是世界上艾滋病毒流行率最高的国家（42%）。由于在非洲的一些地区减少了抗逆转录病毒治疗的推广，加强艾滋病预防治疗支持机制比以往任何时候都更加关键。一种模式可能是社区家庭护理（CHBC），这是世界银行非洲多国艾滋病毒/艾滋病方案的核心特征。然而，这些实体以及地方教会的一线活动仍然没有得到充分探索。本文是斯威士兰宗教与艾滋病病毒/艾滋病的更大人类学研究的一部分，它借鉴了 20 名半结构化护理人员访谈，以了解动机、感知客户需求、护理实践和宗教意义的模式。13 名参与者是护理协调员，他们监督着大约 455 名护理人员，这些护理人员分布在服务的 22 个社区中的近一半。扎根理论分析表明，护理人员在艾滋病毒检测、艾滋病毒披露、治疗的接受/坚持以及减少艾滋病毒耻辱感方面，协助做出了至关重要的决定。同样重要的是，基督教精神的重要性，以“谈话”和“爱”的形式，作为关键的文化背景下的护理实践。自 2006 年至 2009 年，该组织已扩展到约 600 名护理人员和 2500 名家庭护理客户，参与者的报告暗示他们作为更广泛社会变革推动者的角色。本文为不断扩大的 RHA 研究做出了贡献，并挑战了权威的全球公共卫生战略，这些战略在很大程度上忽视了艾滋病毒/艾滋病的当地宗教方面。未来的应用研究需要检查“家庭”和“教堂”如何成为正式卫生服务和艾滋病毒规划之外但不可或缺的重要公共卫生场所。
