Richards Esther, Zalwango Flavia, Seeley Janet, Scholten Francien, Theobald Sally
a Liverpool School of Tropical Medicine , Liverpool , L3 5QA , UK.
Afr J AIDS Res. 2013 Nov;12(2):71-8. doi: 10.2989/16085906.2013.831361.
This study explored how women's and men's gendered experiences from childhood to old age have shaped their vulnerability in relation to HIV both in terms of their individual risk of HIV and their access to and experiences of HIV services. It was a small scale-scale study conducted in urban and rural sites in Uganda between October 2011 and March 2012. The study used qualitative methods: in-depth interviews (with 31 participants) and focus group discussions (FGDs) with older women (2) and men (2) in urban and rural sites and 7 key informant interviews (KIIs) with stakeholders from government and non-government agencies working on HIV issues. Women's position, the cultural management of sex and gender and contextual stigma related to HIV and to old age inter-relate to produce particular areas of vulnerability to the HIV epidemic among older women and men. Women report the compounding factor of gender-based violence marking many of their sexual relationships throughout their lives, including in older age. Both women and men report extremely fragile livelihoods in their old age. Older people are exposed to HIV through multiple and intersecting drivers of risk and represent an often neglected population within health systems. Research and interventions need to go beyond only conceptualising older people as 'carers' to better address their gendered vulnerabilities to HIV in relation to all aspects of policy and programming.
本研究探讨了从童年到老年，女性和男性基于性别的经历如何塑造了他们在艾滋病病毒方面的脆弱性，包括他们感染艾滋病病毒的个人风险以及他们获得艾滋病病毒服务的机会和体验。这是一项于2011年10月至2012年3月在乌干达城乡地区开展的小规模研究。该研究采用了定性方法：对城市和农村地区的31名参与者进行了深入访谈，与老年女性（2组）和男性（2组）进行了焦点小组讨论，并与从事艾滋病病毒问题工作的政府和非政府机构的利益相关者进行了7次关键 informant 访谈。女性的地位、性与性别的文化管理以及与艾滋病病毒和老年相关的背景耻辱感相互关联，在老年女性和男性中产生了对艾滋病疫情的特定脆弱领域。女性报告称，基于性别的暴力这一复合因素贯穿她们一生的许多性关系，包括老年时期。女性和男性都报告称，他们老年时的生计极其脆弱。老年人通过多种相互交织的风险驱动因素接触到艾滋病病毒，并且在卫生系统中往往是被忽视的人群。研究和干预措施需要超越仅仅将老年人概念化为“照顾者”，以便在政策和规划各方面更好地应对他们在艾滋病病毒方面的性别脆弱性。
