Angotti Nicole, Mojola Sanyu A, Schatz Enid, Williams Jill R, Gómez-Olivé F Xavier
a Department of Sociology , American University , Washington, DC , USA.
b MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), Faculty of Health Sciences, School of Public Health , University of the Witwatersrand , Johannesburg , South Africa.
Cult Health Sex. 2018 Mar;20(3):262-275. doi: 10.1080/13691058.2017.1340670. Epub 2017 Jul 25.
Older adults have been largely overlooked in community studies of HIV in highly endemic African countries. In our rural study site in Mpumalanga Province, South Africa, HIV prevalence among those aged 50 and older is 16.5%, suggesting that older adults are at risk of both acquiring and transmitting HIV. This paper utilises community-based focus-group interviews with older rural South African men and women to better understand the normative environment in which they come to understand and make decisions about their health as they age in an HIV endemic setting. We analyse the dimensions of an inductively emerging theme: ku ti hlayisa (to take care of yourself). For older adults, 'taking care' in an age of AIDS represented: (1) an individualised pathway to achieving old-age respectability through the taking up of responsibilities and behaviours that characterise being an older person, (2) a set of gendered norms and strategies for reducing one's HIV risk, and (3) a shared responsibility for attenuating the impact of the HIV epidemic in the local community. Findings reflect the individual, interdependent and communal ways in which older rural South Africans understand HIV risk and prevention, ways that also map onto current epidemiological thinking for improving HIV-related outcomes in high-prevalence settings.
在非洲艾滋病高发国家的社区艾滋病研究中，老年人基本被忽视了。在我们位于南非姆普马兰加省的农村研究地点，50岁及以上人群中的艾滋病病毒感染率为16.5%，这表明老年人存在感染和传播艾滋病病毒的风险。本文通过对南非农村老年男性和女性进行基于社区的焦点小组访谈，以更好地了解在艾滋病流行环境中，他们随着年龄增长逐渐理解自身健康并做出相关决策时所处的规范环境。我们分析了一个归纳得出的主题维度：ku ti hlayisa（照顾好自己）。对于老年人而言，在艾滋病时代“照顾好自己”意味着：（1）通过承担起作为老年人应有的责任和行为，从而实现老年尊严的个体化途径；（2）一套减少个人感染艾滋病病毒风险的性别化规范和策略；（3）减轻艾滋病疫情对当地社区影响的共同责任。研究结果反映出南非农村老年人理解艾滋病病毒风险及预防的个人、相互依存和社区层面的方式，这些方式也与当前在高流行环境中改善艾滋病相关结果的流行病学思维相契合。
