“就像一颗滴答作响的定时炸弹”：纽约市男男性行为者艾滋病毒诊断经历中的创伤持续存在。
"Like a ticking time bomb": the persistence of trauma in the HIV diagnosis experience among black men who have sex with men in New York City.
机构信息
Division of Infectious Disease, Department of Internal Medicine, Columbia University Medical Center, 630 W. 168th St., P&S Box 82, New York, NY, 10032, USA.
North Jersey Community Research Initiative, Newark, NJ, USA.
出版信息
BMC Public Health. 2020 Aug 17;20(1):1247. doi: 10.1186/s12889-020-09342-9.
BACKGROUND
Black men who have sex with men (MSM) are disproportionately affected by HIV compared to almost every other demographic group in the country and have worse outcomes along the care continuum. Diagnosis is a critical juncture. This study aims to explore the impact and meaning of an HIV diagnosis for Black MSM, and how this has changed over time, both for the individual's experience living with HIV as well as for Black MSM in general.
METHODS
From 2017 to 2018, we conducted in-depth interviews with 16 black MSM living with HIV in New York City diagnosed between 1985 and 2016.
RESULTS
Inductive analysis of the qualitative data allowed three major themes to emerge: diagnosis trauma, lack of patient -centeredness in the healthcare system, and acceptance of HIV diagnosis over time.
CONCLUSIONS
This small pilot study signals that an HIV diagnosis experience possibly remains traumatic for black MSM even in the era of highly effective ART, and they often perceive a lack of patient-centeredness in the delivery of a new diagnosis. This has persisted over time. In most cases, black MSM in our sample overcame this trauma due to self-motivation, social support and seeking out and fostering trusting relationships with their HIV provider and the healthcare system.
背景
与全国几乎其他所有人群相比，男男性行为者（MSM）中的黑人受 HIV 影响的比例不成比例，并且在整个护理连续体中结果更差。诊断是一个关键的转折点。本研究旨在探索 HIV 诊断对黑人 MSM 的影响和意义，以及随着时间的推移，这对个人感染 HIV 的体验以及对黑人 MSM 整体的影响。
方法
2017 年至 2018 年，我们对 16 名居住在纽约市的感染 HIV 的黑人 MSM 进行了深入访谈，这些人被诊断出 HIV 的时间在 1985 年至 2016 年之间。
结果
对定性数据的归纳分析产生了三个主要主题：诊断创伤、医疗体系中缺乏以患者为中心的服务，以及随着时间的推移对 HIV 诊断的接受。
结论
这项小型试点研究表明，即使在高效抗逆转录病毒治疗（ART）时代，HIV 诊断对黑人 MSM 来说仍然可能是创伤性的，他们常常认为在新诊断的提供中缺乏以患者为中心的服务。这种情况随着时间的推移而持续存在。在大多数情况下，我们研究样本中的黑人 MSM 通过自我激励、社会支持以及寻求和培养与他们的 HIV 提供者和医疗体系的信任关系，克服了这种创伤。
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