Kulane Asli, Owuor John O A, Sematimba Douglas, Abdulahi Sacdia Abdisamad, Yusuf Hamdi Moalim, Mohamed Lul M
Equity and Health Policy Research Group, Department of Public Health Sciences, Karolinska Institute, Tomtebodavägen 18a, Widerströmska Huset, 171 77 Stockholm, Sweden.
Centre for Global Health (CGH), Trinity College Dublin, The University of Dublin, College Green, Dublin 2, Ireland.
Int J Environ Res Public Health. 2017 Jul 5;14(7):721. doi: 10.3390/ijerph14070721.
Human Immunodeficiency Virus (HIV) continues to take a heavy toll on the lives of many people, with the worst impact on health and wellbeing for the affected individuals in fragile states. The HIV situation in Somalia is not clearly known and experiences of the people living with HIV in this war-torn region are often unexpressed. This pilot qualitative study sought to explore the experiences of people diagnosed with HIV living in Mogadishu, and their resilience in access to care and social support.
Participants were recruited through drug dispensers at the HIV clinic in Banadir Hospital. Face-to-face in-depth interviews were conducted in Somali in May 2013 among patients who were receiving antiretroviral therapy (ART) from the HIV clinic in Mogadishu. These were tape-recorded, transcribed, and translated for content analysis.
Three women and four men who were living with HIV shared the following narratives. Their perception was that they had either got HIV from their spouses or through health care contamination. They were very knowledgeable about the realities of HIV, how the medication works, nutritional requirements, and drug adherence. They were always willing to go an extra mile to secure a good life for themselves. However, the external HIV stigma impacted their access to care. They faced challenges in their homes and at work which compelled them to seek support from non-governmental organizations (NGOs) or close family members. This stigma often affected their disclosure to the wider community due to the uncertainty of the repercussions, leading to a life of extreme loneliness and financial difficulties. The participants' coping mechanisms included living together and starting their own NGO for support with very strong optimism about their prognosis.
The people diagnosed with HIV living in Mogadishu are highly knowledgeable about HIV transmission, the realities of living with a diagnosed HIV infection, and the efficacy of HIV treatment. Our small sample suggests adequate access to ART through NGOs. However, widespread HIV stigma limits HIV status disclosure to families and communities, which creates a risk of self-isolation and ill health. Still, affected individuals have developed resilient mechanisms for managing the risks. They strive to remain employed for economic security, adhere to HIV treatment, engage in support groups, and maintain the utmost optimism about their prognosis.
人类免疫缺陷病毒（HIV）继续给许多人的生命造成沉重损失，对脆弱国家中受影响个体的健康和福祉产生最严重的影响。索马里的HIV情况尚不清楚，在这个饱受战争蹂躏的地区，感染HIV者的经历往往未得到表达。这项定性研究试点旨在探索在摩加迪沙被诊断感染HIV者的经历，以及他们在获得护理和社会支持方面的适应能力。
通过巴纳迪尔医院HIV诊所的药剂师招募参与者。2013年5月，在摩加迪沙HIV诊所接受抗逆转录病毒疗法（ART）的患者中，用索马里语进行了面对面的深入访谈。访谈内容进行了录音、转录和翻译，以进行内容分析。
三名感染HIV的女性和四名男性分享了以下经历。他们认为自己要么从配偶那里感染了HIV，要么是通过医疗保健感染的。他们对HIV的现实情况、药物作用方式、营养需求和药物依从性非常了解。他们总是愿意付出额外的努力来为自己争取美好的生活。然而，外部对HIV的污名化影响了他们获得护理的机会。他们在家庭和工作中面临挑战，这迫使他们寻求非政府组织（NGO）或近亲的支持。由于后果的不确定性，这种污名化常常影响他们向更广泛社区的披露，导致极度孤独和经济困难的生活。参与者的应对机制包括共同生活，并创办自己的非政府组织以获得支持，他们对自己的预后非常乐观。
在摩加迪沙被诊断感染HIV的人对HIV传播、感染HIV后的现实情况以及HIV治疗的疗效非常了解。我们的小样本表明通过非政府组织能够充分获得抗逆转录病毒疗法。然而，普遍存在的HIV污名化限制了向家庭和社区披露HIV感染状况，这会带来自我隔离和健康不佳的风险。尽管如此，受影响的个体已经形成了应对风险的适应机制。他们努力保持就业以保障经济安全，坚持接受HIV治疗，参加支持小组，并对自己的预后保持极度乐观的态度。
