多层污名与艾滋病毒感染和传播的脆弱性:津巴布韦男男性行为者的定性研究。
Multilayered Stigma and Vulnerabilities for HIV Infection and Transmission: A Qualitative Study on Male Sex Workers in Zimbabwe.
机构信息
1 City University of Hong Kong, Hong Kong.
2 University of South Carolina, USA.
出版信息
Am J Mens Health. 2019 Jan-Feb;13(1):1557988318823883. doi: 10.1177/1557988318823883.
Male sex workers are marginalized in most societies due to intersectional stigma between prostitution and homosexuality. In Zimbabwe, a proliferation of male sex workers in major cities such as Harare and Bulawayo has been reported. However, there is a shortage of studies that explore their lives. The current qualitative study aims to describe the practices of sex work, life contexts, and HIV risks and vulnerabilities based on in-depth interviews among 15 male sex workers in Bulawayo. Our studies suggest that the stigma against male sex workers comes from diverse sectors including culture ("homosexuality is un-African, introduced by the Whites"), religion ("same sex is a sin before the God"), law and police ("homosexuality is illegal in Zimbabwe. Engaging in it can send one to prison"), media ("the media is hostile to sex workers particularly men as we are regarded as abnormal and unclean"), and their family ("should they get to know about it, they will disown me"). In this context, male sex workers were excluded from national HIV prevention and treatment programs. They had limited knowledge and many misconceptions about HIV. The stigma and discrimination from health-care providers also discouraged them from health seeking or HIV testing. The non-disclosure to female partners of convenience and sexual relations further increased their vulnerabilities to HIV infection and transmission. Current efforts to address the HIV epidemic should pay attention to male sex workers and tackle the intersecting stigma issues. male sex workers need support and tailored HIV prevention and treatment services to improve their HIV prevention practices, health, and well-being.
男男性行为者在大多数社会中由于卖淫和同性恋之间的交叉污名而处于边缘地位。在津巴布韦,据报道,哈拉雷和布拉瓦约等主要城市的男男性行为者激增。然而,缺乏探索他们生活的研究。目前的定性研究旨在描述性工作实践、生活背景以及基于在布拉瓦约的 15 名男男性行为者进行的深入访谈的艾滋病毒风险和脆弱性。我们的研究表明,对男男性行为者的污名来自多个领域,包括文化(“同性恋是非非洲的,是白人带来的”)、宗教(“同性是在上帝面前的罪恶”)、法律和警察(“在津巴布韦,同性恋是非法的。从事这种行为可能会被送进监狱”)、媒体(“媒体对性工作者特别是男性怀有敌意,因为我们被视为不正常和不洁净的”)和他们的家庭(“如果他们知道了,他们会和我断绝关系”)。在这种情况下,男男性行为者被排除在国家艾滋病毒预防和治疗方案之外。他们对艾滋病毒的了解有限,存在许多误解。来自医疗保健提供者的污名和歧视也阻止了他们寻求健康或接受艾滋病毒检测。对女性伴侣隐瞒方便和性关系进一步增加了他们感染和传播艾滋病毒的脆弱性。当前应对艾滋病毒流行的努力应关注男男性行为者,并解决交叉污名问题。男男性行为者需要支持和量身定制的艾滋病毒预防和治疗服务,以改善他们的艾滋病毒预防实践、健康和福祉。