Division of Public Health & Policy, Institute of Psychology, Health & Society, The University of Liverpool, 3rd Floor, Whelan Building, 1-5 Brownlow Street, Liverpool L69 3GL, UK.
BMC Public Health. 2012 Oct 30;12:926. doi: 10.1186/1471-2458-12-926.
A small body of evidence demonstrates the challenges faced by migrant communities living with HIV but has yet to consider in-depth the experience of asylum seekers whose residency status is undetermined. The overall aim of our study was to explore the experiences of those who are both living with HIV and seeking asylum. This paper focuses on the stressors precipitated by the HIV diagnosis and by going through the asylum system; as well as participants' resilience in responding to these stressors and the consequences for their health and wellbeing.
We conducted an ethnographic study. Fieldwork took place in the UK between 2008-2009 and included: 350 hours of observation at voluntary services providing support to black and minority ethnic groups living with HIV; 29 interviews and four focus group discussions with those who were seeking asylum and living with HIV; and 15 interviews with their health and social care providers. Data were analysed using the constant comparative method.
There were three main stressors that threatened participants' resilience. First, migration caused them to leave behind many resources (including social support). Second, stigmatising attitudes led their HIV diagnosis to be a taboo subject furthering their isolation. Third, they found themselves trapped in the asylum system, unable to influence the outcome of their case and reliant on HIV treatment to stay alive. Participants were, however, very resourceful in dealing with these experiences. Resilience processes included: staying busy, drawing on personal faith, and the support received through HIV care providers and voluntary organisations. Even so, their isolated existence meant participants had limited access to social resources, and their treatment in the asylum system had a profound impact on perceived health and wellbeing.
Asylum seekers living with HIV in the UK show immense resilience. However, their isolation means they are often unable to deal with their treatment in the asylum system, with negative consequences for their perceived health and wellbeing.
有少量证据表明，感染艾滋病毒的移民群体面临着各种挑战，但尚未深入研究那些居住身份尚未确定的寻求庇护者的经历。我们研究的总体目标是探讨那些同时感染艾滋病毒和寻求庇护的人的经历。本文重点介绍艾滋病毒诊断和寻求庇护过程中引发的压力源；以及参与者应对这些压力源的韧性，以及对他们的健康和幸福的影响。
我们进行了一项民族志研究。2008-2009 年在英国进行实地工作，包括：在为感染艾滋病毒的少数族裔群体提供支持的志愿机构观察 350 小时；与寻求庇护和感染艾滋病毒的人进行 29 次访谈和 4 次焦点小组讨论；并对 15 名他们的卫生和社会保健提供者进行访谈。使用恒比法对数据进行分析。
有三个主要的压力源威胁到参与者的适应力。首先，移民使他们离开许多资源（包括社会支持）。其次，污名化的态度使他们的艾滋病毒诊断成为一个禁忌话题，进一步使他们孤立无援。第三，他们发现自己被困在庇护制度中，无法影响案件的结果，只能依靠艾滋病毒治疗来维持生命。然而，参与者在应对这些经历时非常有创造力。适应力过程包括：保持忙碌、依靠个人信仰，以及从艾滋病毒护理提供者和志愿组织获得的支持。即便如此，他们孤立的存在意味着参与者获得社会资源的机会有限，他们在庇护制度中的待遇对他们感知到的健康和幸福感产生了深远的影响。
在英国，感染艾滋病毒的寻求庇护者表现出极大的适应力。然而，他们的孤立意味着他们往往无法应对庇护制度中的治疗，这对他们感知到的健康和幸福感产生了负面影响。
