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比利时医疗环境中对感染艾滋病毒/艾滋病的撒哈拉以南非洲移民妇女的耻辱感和歧视认知:一项定性研究

PERCEPTIONS OF STIGMA AND DISCRIMINATION IN HEALTH CARE SETTINGS TOWARDS SUB-SAHARAN AFRICAN MIGRANT WOMEN LIVING WITH HIV/AIDS IN BELGIUM: A QUALITATIVE STUDY.

作者信息

Arrey Agnes Ebotabe, Bilsen Johan, Lacor Patrick, Deschepper Reginald

机构信息

*Mental Health and Wellbeing Research Group,Department of Public Health,Vrije Universiteit Brussel,Brussels,Belgium.

†Department of Internal Medicine and Infectious Diseases-AIDS Reference Centre,Universitair Ziekenhuis Brussel,Brussels,Belgium.

出版信息

J Biosoc Sci. 2017 Sep;49(5):578-596. doi: 10.1017/S0021932016000468. Epub 2016 Oct 3.

Abstract

Stigma and discrimination within health care settings remain a public health challenge across diverse cultural environments and may have deleterious effects on mental and physical health. This study explores the causes, forms and consequences of HIV-related stigma and discrimination among migrant sub-Saharan African women living with HIV in Belgium. A qualitative study was conducted with 44 HIV-positive sub-Saharan African migrant women between April 2013 and December 2014 in health care settings in Belgium. Data were analysed using thematic content analysis. Twenty-five of the women reported overt stigma and discrimination and fifteen reported witnessing behaviours that they perceived to be stigmatizing and discriminatory in health care settings. The themes that emerged as to the causes of stigma and discrimination were: public perceptions of migrants and HIV, fear of contamination and institutional policies on HIV management. Reported forms of stigma and discrimination included: delayed or denied care, excessive precautions, blame and humiliation. The consequences of stigma and discrimination were: emotional stress, inconsistent health-care-seeking behaviour and non-disclosure to non-HIV treating personnel. Stigma and discrimination in health care settings towards people with HIV, and more specifically towards HIV-positive sub-Saharan African migrant women, impedes sustainable preventive measures. Specialized education and training programmes for non-HIV health care providers require in-depth investigation.

摘要

在不同文化环境中,医疗保健机构内的耻辱感和歧视仍然是一项公共卫生挑战,可能会对身心健康产生有害影响。本研究探讨了比利时感染艾滋病毒的撒哈拉以南非洲移民妇女中与艾滋病毒相关的耻辱感和歧视的原因、形式及后果。2013年4月至2014年12月期间,在比利时的医疗保健机构对44名艾滋病毒呈阳性的撒哈拉以南非洲移民妇女进行了一项定性研究。采用主题内容分析法对数据进行了分析。25名妇女报告遭受了公开的耻辱和歧视,15名妇女报告目睹了她们认为在医疗保健机构中具有耻辱性和歧视性的行为。关于耻辱和歧视原因出现的主题有:公众对移民和艾滋病毒的看法、对感染的恐惧以及艾滋病毒管理方面的机构政策。报告的耻辱和歧视形式包括:护理延迟或被拒绝、过度预防措施、指责和羞辱。耻辱和歧视的后果有:情绪压力、寻求医疗保健行为不一致以及不向非艾滋病毒治疗人员透露病情。医疗保健机构中对艾滋病毒感染者,尤其是对艾滋病毒呈阳性的撒哈拉以南非洲移民妇女的耻辱和歧视,阻碍了可持续的预防措施。针对非艾滋病毒医疗保健提供者的专业教育和培训项目需要深入调查。

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