Lim Jane Mingjie, Tan Rayner Kay Jin, Chan Jeremiah Kah Wai
Saw Swee Hock School of Public Health, National University of Singapore and National University Health System (NUHS), Singapore.
Department of Anthropology, Durham University, Durham, UK.
AIDS Care. 2020 May;32(sup2):142-147. doi: 10.1080/09540121.2020.1742865. Epub 2020 Mar 19.
Gay, bisexual, and other men who have sex with men (GBMSM) are a key population that is disproportionately affected by HIV. However, few studies have explored how and why disclosure of HIV status occurs in this population. To understand disclosure in the context of other socioecological factors, we conducted a qualitative study among 24 self-identified HIV-positive GBMSM, aged 21 and above, and who were Singaporean residents. Analysis of participants' interviews revealed that disclosure of HIV status was not a binary event; rather, each type of disclosure held varying degrees of positive and negative ramifications. Disclosure and self-acknowledgement of HIV status at each time point also had different consequences for participants' quality of life. Suggested potential interventions include increasing training for medical professionals and public awareness surrounding issues relating to HIV. Findings from this study provide a framework to describe the complexities that accompany serostatus disclosure in a setting where there are prevalent "shame-based", negative attitudes towards HIV. As such, this framework can also be utilized in the future planning and organization of services for this target population in similar contexts.
男同性恋者、双性恋者以及其他与男性发生性行为的男性（GBMSM）是受艾滋病毒影响尤为严重的关键人群。然而，很少有研究探讨该人群中艾滋病毒感染状况披露的方式及原因。为了在其他社会生态因素背景下理解披露情况，我们对24名自我认定为艾滋病毒呈阳性、年龄在21岁及以上的新加坡居民GBMSM进行了一项定性研究。对参与者访谈的分析表明，艾滋病毒感染状况的披露并非是一个二元事件；相反，每种披露类型都有着不同程度的积极和消极影响。在每个时间点披露和自我承认艾滋病毒感染状况对参与者的生活质量也有不同影响。建议的潜在干预措施包括加强对医疗专业人员的培训以及提高公众对与艾滋病毒相关问题的认识。本研究结果提供了一个框架，用于描述在对艾滋病毒存在普遍的“基于羞耻感”的负面态度的背景下，血清学状态披露所伴随的复杂性。因此，该框架未来也可用于为类似背景下的这一目标人群规划和组织服务。
