Research Chair in Innovative Nursing Practices, Research Center of the Centre hospitalier de l'Université de Montréal, Montreal, Quebec, Canada.
BMC Womens Health. 2012 Oct 18;12:37. doi: 10.1186/1472-6874-12-37.
In Canada, there has been a considerable increase in the number of women infected with the human immunodeficiency virus (HIV). Within a stigmatized social context, disclosure of HIV positivity is still a prevailing concern among women. Little is known about the global understanding of how French-speaking, Quebec-born women living with HIV, live their serostatus disclosure experience. The aim of this qualitative study is to describe and understand the disclosure experience of these women.
We conducted semi-structured interviews with seven women. A convenience sample of French-speaking, Quebec-born women was chosen because they all responded to the criteria of wishing to share their disclosure experience. The mean age of the participants was 46 years old (SD±12). They lived with HIV for an average of 10 years; time since diagnosis varied from 8 months to 23 years. Two out of four mothers had given birth to HIV positive children. Data analysis proposed by van Manen was performed to discover the essential themes of the experience.
Seven themes were identified to understand the experience of disclosure in women: 1) Respecting for self and confidants; 2) Feeling apprehension; 3) Exercising control to ensure protection; 4) Deliberately engaging in a process of disclosure/non-disclosure; 5) Exposing oneself to stigma and social exclusion; 6) Suffering internally; and 7) Benefitting from the positive effects of one's decision. For these women, disclosing their HIV status meant: Living the ambivalence of a paradoxical process of revealing/concealing, in a state of profound suffering, exacerbated by stigma, while also being enriched by the benefits attained.
Understanding the experience of disclosure in WLHIV is important to guide actions in the practice to support and accompany these women in their unique reality. Health professionals have to broaden their role and work on individual, interpersonal, inter-organizational and intersectoral levels. Mobilization of actors from different sectors would facilitate the implementation of pertinent and opportune interventions.
在加拿大,感染人类免疫缺陷病毒 (HIV) 的妇女人数显著增加。在污名化的社会环境中,HIV 阳性的披露仍然是妇女普遍关注的问题。对于讲法语、出生在魁北克的感染 HIV 的妇女如何理解和经历 HIV 阳性的披露,我们知之甚少。本定性研究旨在描述和理解这些妇女的披露经历。
我们对 7 名妇女进行了半结构化访谈。选择讲法语、出生在魁北克的方便样本的目的是,她们都符合希望分享自己披露经验的标准。参与者的平均年龄为 46 岁(SD±12)。她们平均感染 HIV 10 年;从诊断到现在的时间从 8 个月到 23 年不等。4 位母亲中有 2 位生育了 HIV 阳性的孩子。采用范马南提出的数据分析法来发现经验的基本主题。
为了理解妇女披露经历,确定了 7 个主题:1)尊重自己和知己;2)感到焦虑;3)控制自己以确保保护;4)有意进行披露/不披露的过程;5)暴露于污名和社会排斥;6)内心痛苦;7)从决定的积极影响中受益。对这些妇女来说,披露 HIV 状况意味着:在一种揭示/隐瞒的矛盾过程中,生活在一种深刻的痛苦中,这种痛苦因污名而加剧,同时也因所获得的益处而丰富。
了解 WLHIV 的披露经历对于指导实践中的行动至关重要,以支持和陪伴这些妇女度过独特的现实。卫生专业人员必须扩大他们的角色,在个人、人际、组织间和部门间层面开展工作。动员来自不同部门的行为者将有助于实施相关和适时的干预措施。