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[来自西非的移民艾滋病毒患者的表征与疾病叙事]

[Representations and illness narratives in migrants HIV-patients originating from West Africa].

作者信息

Douine Maylis, Bouchaud Olivier, Moro Marie-Rose, Baubet Thierry, Taïeb Olivier

机构信息

AP-HP, hôpital Avicenne, université Paris 13, service de maladies infectieuses et tropicales, 93000 Bobigny, France.

出版信息

Presse Med. 2012 Apr;41(4):e204-12. doi: 10.1016/j.lpm.2011.09.029. Epub 2011 Dec 16.

Abstract

OBJECTIVE

Migrants, especially from West African countries, are highly affected by HIV in France but their representations of the illness have not been much studied. The aim of this study is to explore their representations of HIV infection through their explanatory models and etiologic theories.

METHOD

Nine interviews of patients living with HIV from West African countries and migrants in France have been carried out with the Mac Gill Illness Narrative Interview, an interview schedule to elicit meanings and modes of reasoning related to illness experience. The illness narratives have then been analyzed through a method from medical anthropology.

FINDINGS

According to this study, AIDS remains a shameful illness, related to immoral behaviors such as unfaithfulness, intercourses with prostitutes or a high number of partners. Causality of illness is often related to the migration story. Stigmatization of people living with HIV is prevailing in the personal experience of the illness, which leads to underestimate oneself, to stop making plans for the future and brings social loneliness because of the secret around this illness.

CONCLUSION

Like any illness, diagnosis of HIV infection involves questions: "Why me? Why now?" requiring an interpretation to recreate coherence in patients' lives. For medicals, caring about illnesses representations of the patients helps therapeutic relationship. Complementary surveys lead by a multidisciplinary team and an interpreter at different times could improve understandings of global representations of illness and their evolution.

摘要

目的

移民,尤其是来自西非国家的移民,在法国受艾滋病毒影响严重,但他们对这种疾病的认知却鲜有研究。本研究旨在通过他们的解释模型和病因理论来探索他们对艾滋病毒感染的认知。

方法

采用麦吉尔疾病叙事访谈法,对9名来自西非国家的艾滋病毒感染者及法国的移民进行了访谈,该访谈提纲旨在引出与疾病经历相关的意义和推理方式。然后通过医学人类学的方法对疾病叙事进行了分析。

结果

根据本研究,艾滋病仍然是一种可耻的疾病,与不忠、与妓女交往或性伴侣众多等不道德行为有关。疾病的因果关系往往与移民经历有关。在疾病的个人经历中,艾滋病毒感染者遭受污名化的情况很普遍,这导致感染者自卑,不再为未来做规划,并因围绕这种疾病的秘密而陷入社交孤立。

结论

与任何疾病一样,艾滋病毒感染的诊断会引发“为什么是我?为什么是现在?”这样的问题,需要一种解释来重建患者生活中的连贯性。对于医护人员来说,关注患者对疾病的认知有助于建立治疗关系。由多学科团队和口译员在不同时间进行的补充调查可以增进对疾病整体认知及其演变的理解。

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