Midtbø Vivian, Shirima Violeth, Skovdal Morten, Daniel Marguerite
a Department of Health Promotion and Development , University of Bergen , Christiesgt. 13 , 5015 , Bergen , Norway.
Afr J AIDS Res. 2012 Oct;11(3):261-71. doi: 10.2989/16085906.2012.734987.
HIV-related stigma has a major impact on the health and psychosocial wellbeing of HIV-infected children and youths. While there is some debate about the extent to which improved access to antiretroviral therapy (ART) contributes to a reduction in HIV stigma, we know little about how adolescents who know their HIV status and who are enrolled in ART experience and cope with stigma. The aim of the research was to understand and identify the pathways between HIV-status disclosure, ART, and children's psychosocial wellbeing, including from the perspective of adolescents themselves. Two qualitative studies were carried out, in Botswana and Tanzania, in 2011: 16 adolescents and three healthcare workers were enrolled in Botswana, and 12 adolescents and two healthcare workers were enrolled in Tanzania. The data were collected through individual and group interviews as well as participant observation. The recorded interviews were transcribed and analysed using thematic network analysis. The findings indicate that HIV-status disclosure enabled adolescents to engage effectively with their ART treatment and support groups, which in turn provided them with a sense of confidence and control over their lives. Although the adolescents in the two studies were still experiencing stigma from peers and community members, most did not internalise these experiences in a negative way, but retained hope for the future and felt pity for those untested and uninformed of their own HIV status. We conclude that disclosure and good HIV-related services provide an important platform for HIV-infected adolescents to resist and cope with HIV stigma.
与艾滋病病毒相关的污名化对感染艾滋病病毒的儿童和青少年的健康及心理社会福祉产生重大影响。尽管对于改善抗逆转录病毒疗法（ART）的可及性在多大程度上有助于减少艾滋病病毒污名化存在一些争议，但我们对那些知晓自己感染状况并接受抗逆转录病毒疗法的青少年如何体验和应对污名化却知之甚少。该研究的目的是了解并确定艾滋病病毒感染状况披露、抗逆转录病毒疗法与儿童心理社会福祉之间的关联途径，包括从青少年自身的角度。2011年在博茨瓦纳和坦桑尼亚开展了两项定性研究：博茨瓦纳有16名青少年和3名医护人员参与，坦桑尼亚有12名青少年和2名医护人员参与。数据通过个人访谈、小组访谈以及参与观察收集。对记录的访谈进行转录，并使用主题网络分析法进行分析。研究结果表明，艾滋病病毒感染状况的披露使青少年能够有效地参与抗逆转录病毒疗法治疗及支持小组，这反过来又给他们带来了对自己生活的信心和掌控感。尽管两项研究中的青少年仍遭受来自同龄人和社区成员的污名化，但大多数人并未以消极方式将这些经历内化，而是对未来抱有希望，并对那些未接受检测且不了解自身艾滋病病毒感染状况的人感到同情。我们得出结论，感染状况的披露及良好的艾滋病病毒相关服务为感染艾滋病病毒的青少年抵制和应对艾滋病病毒污名化提供了一个重要平台。
