Janamnuaysook Rena, Green Kimberly Elizabeth, Seekaew Pich, Ngoc Vu Bao, Van Ngo Huu, Anh Doan Hong, Pengnonyang Supabhorn, Vannakit Ravipa, Phanuphak Praphan, Phanuphak Nittaya, Ramautarsing Reshmie Ashmanie
Institute of HIV Research and Innovation, Bangkok, Thailand; and Center of Excellence in Transgender Health, Chulalongkorn University, Bangkok, Thailand; and Corresponding author. Email:
PATH, Hanoi, Vietnam.
Sex Health. 2021 Mar;18(1):13-20. doi: 10.1071/SH20172.
Despite the challenges to the HIV response in the Asia-Pacific, a demedicalisation of HIV intervention has been demonstrated to be an important strategy to maximise the uptake of HIV prevention tools among key populations in this region. Demedicalisation of HIV interventions translates medical discourse and shifts the paradigm from a disease-focused to a people-centred approach. It also recognises real-life experiences of key populations in the HIV response by empowering them to voice their needs and be at the forefront of the epidemic control. We further categorise a demedicalisation approach into three frameworks: (1) the demystification of clinical or medical concerns; (2) the destigmatisation of people living with HIV; and (3) the decentralisation of healthcare services. This article reviewed the demedicalisation framework by looking at the HIV intervention examples from countries in the Asia-Pacific, which included: (1) a study on drug-drug interaction between pre-exposure prophylaxis and feminising hormone treatment for transgender women; (2) the roles of key population-led health services; and (3) certification of key population lay providers.
尽管亚太地区在应对艾滋病方面面临诸多挑战，但事实证明，艾滋病干预的去医学化是该地区关键人群中最大限度推广艾滋病预防工具的一项重要策略。艾滋病干预的去医学化转变了医学话语，并将范式从以疾病为中心转变为以人为本的方法。它还通过赋予关键人群表达自身需求并站在疫情控制前沿的权力，认可了他们在艾滋病应对中的现实生活经历。我们进一步将去医学化方法分为三个框架：（1）消除临床或医学问题的神秘感；（2）消除对艾滋病感染者的污名化；（3）医疗服务的去中心化。本文通过审视亚太地区国家的艾滋病干预实例，对去医学化框架进行了综述，这些实例包括：（1）一项关于暴露前预防与跨性别女性女性化激素治疗之间药物相互作用的研究；（2）关键人群主导的卫生服务的作用；（3）关键人群非专业服务提供者的认证。
