社区对话在促进当地艾滋病防治能力方面的作用：来自津巴布韦农村的案例研究。
The role of community conversations in facilitating local HIV competence: case study from rural Zimbabwe.
机构信息
Institute of Social Psychology, London School of Economics and Political Science, Houghton Street, WC2A 2AE London, UK.
出版信息
BMC Public Health. 2013 Apr 17;13:354. doi: 10.1186/1471-2458-13-354.
BACKGROUND
This paper examines the potential for community conversations to strengthen positive responses to HIV in resource-poor environments. Community conversations are an intervention method through which local people work with a facilitator to collectively identify local strengths and challenges and brainstorm potential strategies for solving local problems.
METHODS
We conducted 18 community conversations (with six groups at three points in time) with a total of 77 participants in rural Zimbabwe (20% HIV positive). Participants were invited to reflect on how they were responding to the challenges of HIV, both as individuals and in community groups, and to think of ways to better support openness about HIV, kindness towards people living with HIV and greater community uptake of HIV prevention and treatment.
RESULTS
Community conversations contributed to local HIV competence through (1) enabling participants to brainstorm concrete action plans for responding to HIV, (2) providing a forum to develop a sense of common purpose in relation to implementing these, (3) encouraging and challenging participants to overcome fear, denial and passivity, (4) providing an opportunity for participants to move from seeing themselves as passive recipients of information to active problem solvers, and (5) reducing silence and stigma surrounding HIV.
CONCLUSIONS
Our discussion cautions that community conversations, while holding great potential to help communities recognize their potential strengths and capacities for responding more effectively to HIV, are not a magic bullet. Poverty, poor harvests and political instability frustrated and limited many participants' efforts to put their plans into action. On the other hand, support from outside the community, in this case the increasing availability of antiretroviral treatment, played a vital role in enabling communities to challenge stigma and envision new, more positive, ways of responding to the epidemic.
背景
本文探讨了社区对话在资源匮乏环境中增强对 HIV 积极应对的潜力。社区对话是一种干预方法，通过这种方法，当地人与促进者合作，共同确定当地的优势和挑战，并集思广益，为解决当地问题提出潜在策略。
方法
我们在津巴布韦农村地区进行了 18 次社区对话（分三个时间点，每次有 6 个小组，共 77 名参与者，其中 20%为 HIV 阳性）。参与者被邀请反思他们如何应对 HIV 带来的挑战，无论是个人还是社区团体，并思考如何更好地支持公开谈论 HIV、善待 HIV 感染者以及提高社区对 HIV 预防和治疗的接受程度。
结果
社区对话通过以下方式促进了当地的 HIV 应对能力：（1）使参与者能够集思广益，制定应对 HIV 的具体行动计划；（2）提供了一个论坛，让参与者在实施这些计划方面形成共同目标感；（3）鼓励和挑战参与者克服恐惧、否认和消极；（4）为参与者提供了一个机会，使他们从被动接受信息的角色转变为积极解决问题的角色；（5）减少了围绕 HIV 的沉默和污名化。
结论
我们的讨论告诫人们，社区对话虽然具有帮助社区认识到自身应对 HIV 的潜在优势和能力的巨大潜力，但并非万无一失。贫困、歉收和政治不稳定挫败并限制了许多参与者将计划付诸行动的努力。另一方面，来自社区外部的支持，在这种情况下是抗逆转录病毒治疗的日益普及，在使社区能够挑战污名化并设想应对疫情的新的、更积极的方式方面发挥了至关重要的作用。
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