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加纳东部地区艾滋病毒/艾滋病感染者的性别分析。

A gendered analysis of living with HIV/AIDS in the Eastern Region of Ghana.

机构信息

Institute of Statistical, Social and Economic Research, University of Ghana - Legon, P. O. Box LG 74, Legon, Ghana.

出版信息

BMC Public Health. 2020 May 24;20(1):751. doi: 10.1186/s12889-020-08702-9.

Abstract

BACKGROUND

A gender gap exists in knowledge regarding persons living with HIV/AIDS in Ghana. Women living with HIV/AIDS (WLHIV) greatly outnumber males living with HIV/AIDS (MLHIV) in Ghana and Sub-Saharan Africa generally. This necessitates more gender-nuanced evidence-based information on HIV/AIDS to guide individuals, healthcare workers, and other stakeholders in Ghana particularly. This paper undertook a gender-focused analysis of the experiences of WLHIV and MLHIV in a municipal area in Ghana which has been most impacted by HIV/AIDS.

METHODS

In-depth interviews of 38 HIV-positive persons recruited using combined purposive and random sampling for one month, were tape recorded and analyzed using thematic content analysis. Participants were out-patients who were receiving routine care for co-morbidities at two specially equipped HIV/AIDS Voluntary Counseling and Testing Centers in the Lower Manya Krobo Municipality (LMKM), Eastern Region, Ghana.

RESULTS

Our data yielded three major themes: characteristics of participants, health status and health seeking behavior, and challenges encountered living with HIV/AIDS. Except for feeling of sadness due to their HIV/AIDS-positive status, there were significant differences in the experiences of MLHIV, compared to WLHIV. WLHIV were more likely to be housing insecure, unemployed due mostly to stigmatization/self-stigmatization, less likely to have revealed their HIV-positive status to multiple family members, and had more profound challenges regarding their healthcare. Most MLHIV expected, demanded, and had support from their wives; WLHIV were mostly single-never married, divorced or widowed (mostly due to HIV/AIDS). The vast majority of WLHIV complained of near-abject poverty, including for most of them, lack of food for taking their anti-retroviral medicines and/or taking it on time.

CONCLUSIONS

The experiences of the MLHIV and WLHIV with living and coping with the virus mostly differed. These experiences were unequivocally shaped by differential socio-cultural tenets and gendered nuances; WLHIV had more negative experiences. Public education on the extra burden of HIV/AIDS on WLHIV, more social support, and affirmative action in policy decisions in favor of WLHIV in the study district are needed to seek public sympathy and improve health outcomes and livelihoods of WLHIV particularly. Further studies using multiple sites to explore these differences are warranted.

摘要

背景

在加纳,人们对感染艾滋病毒/艾滋病者的认识存在性别差距。在加纳和撒哈拉以南非洲,感染艾滋病毒的女性人数大大超过感染艾滋病毒的男性人数。这就需要提供更多针对性别问题的、基于证据的艾滋病毒/艾滋病信息,以指导加纳特别是个人、卫生保健工作者和其他利益攸关方。本文对加纳一个受艾滋病毒/艾滋病影响最大的城市地区的感染艾滋病毒的女性和男性的经历进行了重点分析。

方法

采用混合目的抽样和随机抽样,在一个月内招募了 38 名艾滋病毒呈阳性的人进行深入访谈,对访谈内容进行录音,并采用主题内容分析法进行分析。参与者是在加纳下曼尼克罗博市(Lower Manya Krobo Municipality,LMKM)两个特别配备的艾滋病毒/艾滋病自愿咨询和检测中心接受常规护理的门诊病人,他们患有合并症。

结果

我们的数据产生了三个主要主题:参与者的特征、健康状况和寻求健康的行为以及感染艾滋病毒/艾滋病后的生活所面临的挑战。除了对自己的艾滋病毒阳性状况感到悲伤外,与感染艾滋病毒的男性相比,感染艾滋病毒的女性的经历存在显著差异。感染艾滋病毒的女性更有可能无家可归,大多因污名化/自我污名化而失业,不太可能向多个家庭成员透露自己的艾滋病毒阳性状况,在医疗保健方面面临更大的挑战。大多数感染艾滋病毒的男性都期望、要求并得到妻子的支持;而感染艾滋病毒的女性大多未婚、离婚或丧偶(主要是因为艾滋病毒/艾滋病)。绝大多数感染艾滋病毒的女性都抱怨几乎赤贫,包括对大多数人来说,缺乏抗逆转录病毒药物的食物,或者不能按时服药。

结论

感染艾滋病毒的男性和女性的生活和应对病毒的经历大多不同。这些经历无疑受到了不同的社会文化原则和性别差异的影响;感染艾滋病毒的女性的经历更为负面。需要在研究地区开展公共教育,提高公众对艾滋病毒/艾滋病给感染艾滋病毒的女性带来的额外负担的认识,提供更多的社会支持,并在政策决策中采取有利于感染艾滋病毒的女性的平权行动,以争取公众的同情,改善感染艾滋病毒的女性的健康结果和生计。有必要在多个地点进行进一步研究,以探讨这些差异。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/632f/7245734/85bccbb462e6/12889_2020_8702_Fig1_HTML.jpg

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