Brendstrup E, Schmidt K
Department of Epidemiology, Statens Seruminstitut, Copenhagen, Denmark.
Soc Sci Med. 1990;30(6):713-20. doi: 10.1016/0277-9536(88)90256-0.
This paper describes how the threat of HIV infection is appraised and coped with by homosexual and bisexual men. Very little is known about men who do not want to be HIV tested, thus non-HIV-tested homosexual and bisexual men have been interviewed in depth about themes concerning their lives during the AIDS epidemic. Men with sexual risk behaviour appeared to be very reluctant to participate, and therefore six men with safe sexual behaviour and four men with unsafe sexual behaviour were interviewed. The results showed that all the men were well informed about AIDS and preventive measures. Reasons for not wanting a test were fear of psychological distress caused by a possible positive test and the fact that no treatment is available. The men who had adopted safe sex appraised their sex lives to have suffered a minor loss but found that sexuality played a subordinate role compared to trust and friendship. The men with risk behaviour considered sexuality to play an important role in their lives. They found condoms a barrier to intimacy and used defensive strategies to manage stress. Most of them were able to exchange social support with their network but had difficulties in setting their own limits. All four men had experienced undertreated traumatic events in their past. The results indicate that knowledge of AIDS and satisfactory social support do not necessarily result in safe sexual behaviour. The role of undertreated traumatic events forming barriers against adopting safe sexual practices should be further studied. Proposals are put forward for future health education programmes.
本文描述了男同性恋者和双性恋男性如何评估和应对感染艾滋病毒的威胁。对于那些不想接受艾滋病毒检测的男性，我们了解得很少，因此，我们深入采访了未接受艾滋病毒检测的男同性恋者和双性恋男性，了解他们在艾滋病流行期间生活中的相关主题。有性风险行为的男性似乎非常不愿意参与，因此我们采访了六名有安全性行为的男性和四名有不安全性行为的男性。结果表明，所有男性都对艾滋病和预防措施有充分了解。不想接受检测的原因是担心检测结果呈阳性可能带来的心理困扰，以及目前没有可用的治疗方法。采取安全性行为的男性认为他们的性生活受到了轻微影响，但发现与信任和友谊相比，性在生活中处于次要地位。有风险行为的男性认为性在他们的生活中扮演着重要角色。他们发现避孕套是亲密关系的障碍，并采用防御策略来应对压力。他们中的大多数人能够与自己的社交圈子交换社会支持，但在设定自身界限方面存在困难。所有四名男性过去都经历过未得到充分治疗的创伤性事件。结果表明，对艾滋病的了解和满意的社会支持不一定会导致安全性行为。未得到充分治疗的创伤性事件对采取安全性行为形成障碍的作用应进一步研究。本文还为未来的健康教育项目提出了建议。
