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既非“愚蠢”也未“终结”:马拉维农村地区老年艾滋病毒感染者的身份认同管理

Neither 'foolish' nor 'finished': identity control among older adults with HIV in rural Malawi.

作者信息

Freeman Emily

机构信息

Department of Social Policy, London School of Economics and Political Science, London, UK.

出版信息

Sociol Health Illn. 2017 Jun;39(5):711-725. doi: 10.1111/1467-9566.12531. Epub 2016 Dec 24.

Abstract

Prevalence of HIV after age 50 is considerable, especially in southern Africa. Negative social constructions of HIV in older age, and the health consequences of ageing with the virus, mean that having HIV presents a challenge for many people's roles and social memberships, threatening to disrupt their sense of self. Using constructivist grounded theory and qualitative data from rural Malawi, this paper describes how older men and women deal with these identity challenges. Drawing on a symbolic interactionist framework, it uses identity control theory to explore how the study's participants presented their post-diagnosis behaviours in ways that maintained their most significant pre-diagnosis identities as 'adults', a label they gave to the core identity of being a person who belongs in the social world. Considering the processes through which older people with HIV navigated challenges to their identities in light of the intersectional influences of HIV and age-related stigma and illness, provides insight into how older people might experience HIV, as well as informing theoretical understandings of identity formation and maintenance in light of chronic and/or stigmatising illness more broadly.

摘要

50岁及以上人群中艾滋病毒的流行情况相当严重,尤其是在非洲南部。对老年人感染艾滋病毒的负面社会认知,以及感染病毒后衰老带来的健康后果,意味着感染艾滋病毒对许多人的角色和社会成员身份构成了挑战,有可能破坏他们的自我认知。本文运用建构主义扎根理论和来自马拉维农村的定性数据,描述了老年男性和女性如何应对这些身份认同挑战。基于符号互动主义框架,运用身份控制理论来探讨研究参与者如何通过保持诊断前作为“成年人”这一最重要身份的方式来呈现他们诊断后的行为,“成年人”是他们赋予在社会中作为有归属之人的核心身份的标签。鉴于艾滋病毒与年龄相关的污名和疾病的交叉影响,考虑感染艾滋病毒的老年人应对身份认同挑战的过程,有助于深入了解老年人感染艾滋病毒的经历,也能更广泛地为基于慢性和/或污名化疾病的身份形成和维持的理论理解提供参考。

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