Bureau-Point Eve, Phan Sovannoty
Aix-Marseille University, Marseille, France
Aix-Marseille University, Marseille, France.
Qual Health Res. 2016 Jul;26(9):1263-74. doi: 10.1177/1049732315583269. Epub 2015 Apr 22.
Participation of people living with HIV/AIDS (PLHA) has become a new standard of good governance in HIV services worldwide, and most HIV organizations make reference to it. This standard has had a considerable impact in Cambodia, where hundreds of PLHA have been recruited by organizations to participate in the development of HIV services. However, participation is a vague concept with various interpretations and applications. Drawing on ethnographic research conducted between 2006 and 2008, this article first clarifies what promoters expect from patient participation in Cambodia and then examines its meanings and uses for one category of PLHA working in hospitals (hereafter "volunteers"). It shows that volunteers have played a valuable role in the scaling-up of access to care and treatment policy, and that although international organizations in Cambodia see patient participation as empowering PLHA, these volunteers face structural violence caused by inherent conflicts within Cambodia's strict health care hierarchy.
艾滋病毒/艾滋病感染者（PLHA）的参与已成为全球艾滋病毒服务良好治理的新标准，大多数艾滋病毒组织都以此为参考。这一标准在柬埔寨产生了相当大的影响，在那里，数百名艾滋病毒/艾滋病感染者被各组织招募参与艾滋病毒服务的发展。然而，参与是一个模糊的概念，有各种不同的解释和应用。本文借鉴2006年至2008年进行的人种志研究，首先阐明在柬埔寨推动者对患者参与的期望，然后审视参与对在医院工作的一类艾滋病毒/艾滋病感染者（以下简称“志愿者”）的意义和用途。研究表明，志愿者在扩大护理和治疗政策的可及性方面发挥了宝贵作用，而且尽管柬埔寨的国际组织将患者参与视为增强艾滋病毒/艾滋病感染者的权能，但这些志愿者面临着柬埔寨严格的医疗等级制度中固有冲突所导致的结构性暴力。
