Qiao Shan, Nie Jing-Bao, Tucker Joseph, Rennie Stuart, Li Xiao-Ming
Pediatric Prevention Research Center, School of Medicine, Wayne State University, Detroit, MI 48201, USA.
Bioethics Centre, University of Otago, Dunedin 9054, New Zealand.
Health Psychol Behav Med. 2015;3(1):115-127. doi: 10.1080/21642850.2015.1040405. Epub 2015 Apr 30.
HIV is both a biomedical disease and a social phenomenon that is constructed in particular cultural contexts. A successful and humane HIV cure requires not only the science of eradicating pathogens, but also the art of healing to restore harmony between mind and body. Healing in the context of HIV cure will be both personal and interpersonal, biological and social, and will involve rebuilding connections between HIV patients and their social environment. Social conceptions of healing have been highlighted in many regions with rich non-biomedical healing traditions, including China. Based on an adapted theoretical model on social relationships and health, we address the essential role of social relations for HIV healing in Chinese cultural context, and propose several recommendations for reforming practices and policies regarding HIV healing. In general, family is still a core social unit in HIV patients' medical journey from diagnosis to treatment. A positive patient-physician relationship based on mutual respect and trust also has critical impact on patients' physical and mental health. Physicians may become a key or the main source of social support in circumstances when families are not actively engaged in healing. Reconnecting HIV patients with their communities should be a necessary component of HIV cure, as this will help patients engage more fully in the HIV healing process. We call for a family-centered approach in HIV healing intervention to strengthen patient-family ties; a series of policies to build up and sustain positive patient-physician ties; and multi-level strategies to empower patients and rebuild their bonds to community and larger society. We also call for more empirical research on how non-biomedical healing approaches in various cultural settings could (directly or indirectly) inform HIV cure research.
艾滋病病毒既是一种生物医学疾病,也是一种在特定文化背景下形成的社会现象。成功且人道的艾滋病治愈方法不仅需要根除病原体的科学,还需要治愈的艺术,以恢复身心和谐。在艾滋病治愈的背景下,治愈将涉及个人和人际层面、生物和社会层面,还将包括重建艾滋病患者与其社会环境之间的联系。在包括中国在内的许多拥有丰富非生物医学治愈传统的地区,治愈的社会观念已受到关注。基于一个关于社会关系与健康的适应性理论模型,我们探讨了社会关系在中国文化背景下对艾滋病治愈的重要作用,并就改革艾滋病治愈方面的实践和政策提出了若干建议。总体而言,家庭仍然是艾滋病患者从诊断到治疗的医疗过程中的核心社会单位。基于相互尊重和信任的积极医患关系对患者的身心健康也至关重要。在家庭未积极参与治愈过程的情况下,医生可能成为社会支持的关键或主要来源。让艾滋病患者重新融入其社区应是艾滋病治愈的必要组成部分,因为这将有助于患者更充分地参与艾滋病治愈过程。我们呼吁在艾滋病治愈干预中采取以家庭为中心的方法来加强患者与家庭的联系;制定一系列政策以建立和维持积极的医患关系;以及采取多层次策略来增强患者权能并重建他们与社区及更大社会的联系。我们还呼吁开展更多实证研究,以探讨各种文化背景下的非生物医学治愈方法如何(直接或间接)为艾滋病治愈研究提供信息。