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利用艾滋病毒社区咨询委员会在资源匮乏环境中作为社区行动和健康促进的推动者:来自巴西里约热内卢新伊瓜苏的案例研究。

Utilizing an HIV community advisory board as an agent of community action and health promotion in a low-resource setting: a case-study from Nova Iguaçu, Rio de Janeiro, Brazil.

机构信息

Oswaldo Cruz Foundation, Rio de Janeiro, Brazil.

General Hospital of Nova Iguaçu, Nova Iguaçu, Brazil.

出版信息

Glob Health Promot. 2020 Sep;27(3):56-64. doi: 10.1177/1757975919854045. Epub 2019 Jul 26.

Abstract

INTRODUCTION

Brazil's HIV burden has greatly increased over the past decade, especially for socially marginalized and vulnerable groups such as adolescents, women, and men who have sex with men. The reasoning for worsening HIV outcomes is complex, but ongoing economic and political crises have placed extreme operational and financial burdens on both the public health system and HIV-related civil society, affecting both treatment and prevention efforts and delivery.

CONTEXT

Community-based HIV-related health-promotion activities have continued in Nova Iguaçu, Rio de Janeiro, despite these setbacks. These efforts have been led by a semi-independent community advisory board and engagement group based at the Hospital Geral de Nova Iguaçu with support from researchers based at the Oswaldo Cruz Foundation.

METHODS

The research team supported, documented, and participated in various activities led by the community advisory board and engagement group from 2017-2018 including meetings, community workshops/lectures, production of health promotion materials, and the dissemination of research findings.

RESULTS

The research team utilized the concepts of vernacular knowledge and critical pedagogy to describe and document the ongoing, bottom-up approach, community-led efforts of the community advisory board and engagement group. In particular, we describe the process of stakeholder engagement, popularization of research results, and resource sharing spearheaded by the community advisory board in Nova Iguaçu.

CONCLUSION

The community advisory board demonstrates how community-led efforts are essential to HIV and AIDS response efforts in light of worsening HIV burdens and global shifts towards biomedicalization. Their HIV-related activities rely on existing community networks and resources with secondary support from a research team. This illustrates a key intervention point between traditional research and an empowering community mobilization that can inform similar efforts in other low-resource settings.

摘要

引言

在过去的十年中,巴西的艾滋病毒负担大大增加,尤其是在青少年、妇女和男男性行为者等社会边缘化和弱势群体中。艾滋病毒结局恶化的原因很复杂,但持续的经济和政治危机给公共卫生系统和艾滋病毒相关民间社会带来了巨大的运营和财务压力,影响了治疗和预防工作以及服务的提供。

背景

尽管面临这些挫折,里约热内卢新伊瓜苏的社区为艾滋病毒相关健康促进活动仍在继续。这些努力由一个半独立的社区咨询委员会和参与小组领导,该小组以新伊瓜苏综合医院为基地,并得到来自奥古斯托·克鲁兹基金会的研究人员的支持。

方法

研究团队在 2017 年至 2018 年期间支持、记录并参与了社区咨询委员会和参与小组领导的各种活动,包括会议、社区研讨会/讲座、制作健康促进材料以及传播研究结果。

结果

研究团队利用本土知识和批判教育学的概念来描述和记录社区咨询委员会和参与小组正在进行的、自下而上的、以社区为导向的努力。特别是,我们描述了利益相关者参与、研究结果普及以及社区咨询委员会在新伊瓜苏牵头的资源共享的过程。

结论

社区咨询委员会表明,在艾滋病毒负担不断加重和全球向生物医学化转变的情况下,社区主导的努力对于艾滋病毒和艾滋病应对工作至关重要。他们的艾滋病毒相关活动依赖于现有的社区网络和资源,其次是研究团队的支持。这说明了传统研究和赋权社区动员之间的一个关键干预点,它可以为其他资源匮乏的环境提供类似的努力。

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