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理解 HIV 诊断对苏格兰男同性恋者的影响:一种解释性现象学分析。

Understanding the impact of HIV diagnosis amongst gay men in Scotland: an interpretative phenomenological analysis.

机构信息

Department of Psychology, Glasgow Caledonian University, Glasgow, UK.

出版信息

Psychol Health. 2011 Oct;26(10):1378-91. doi: 10.1080/08870446.2010.551213. Epub 2011 Jun 21.

Abstract

OBJECTIVES

Although a wide literature details the psychological impact of human immunodeficiency virus (HIV) diagnosis, it predates the introduction of effective treatment for HIV (i.e. anti-retroviral therapies, ARTs). This article explores the psychological impact of HIV diagnosis in post-ART accounts. This is important, given the recent policy developments which focus upon increasing HIV testing and thus diagnoses.

DESIGN

This study presents a qualitative exploration of the experiential accounts of HIV-positive gay men living in Scotland. A total of 14 HIV-positive gay men took part in open-ended interviews.

METHODS

Interpretative phenomenological analysis was employed to identify recurrent themes across the interviews.

RESULTS

Our analysis focuses upon the participants' struggles in adjusting to their HIV status. Diagnosis was a deeply shocking and unexpected experience. Stigma and fear of prejudice dominated their accounts. HIV was understood, variously, as a shameful, fatal and life-changing condition. Overall, within these accounts there was little sense of HIV normalisation.

CONCLUSIONS

In Scotland, where HIV prevalence is low, and where no accessible HIV-positive sub-culture exists, there is on-going psychological distress and morbidity amongst gay men testing HIV positive. As HIV-related policy increasingly focuses on increasing rates of antibody testing, there is a need to reduce the psychosocial costs associated with HIV-positive diagnoses.

摘要

目的

尽管有大量文献详细描述了人类免疫缺陷病毒(HIV)诊断对心理的影响,但这些研究都早于有效的 HIV 治疗(即抗逆转录病毒疗法,ARTs)的出现。本文探讨了 ART 出现后的 HIV 诊断对心理的影响。鉴于最近的政策发展侧重于增加 HIV 检测和诊断,这一点很重要。

设计

本研究对苏格兰的 HIV 阳性男同性恋者的经验进行了定性探索。共有 14 名 HIV 阳性男同性恋者参加了开放式访谈。

方法

采用解释现象学分析方法,从访谈中识别出反复出现的主题。

结果

我们的分析集中在参与者适应 HIV 状况的挣扎上。诊断是一个令人深感震惊和意想不到的经历。耻辱感和对偏见的恐惧主导了他们的叙述。HIV 被理解为一种耻辱、致命和改变生活的状况。总的来说,在这些叙述中,很少有 HIV 正常化的感觉。

结论

在苏格兰,HIV 流行率较低,也没有可接触的 HIV 阳性亚文化,HIV 阳性的男同性恋者仍在经历持续的心理困扰和发病率。随着与 HIV 相关的政策越来越关注提高抗体检测率,需要降低与 HIV 阳性诊断相关的社会心理成本。

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