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“同伴教育者是我人生的改变者”:刚果民主共和国感染艾滋病毒青少年对同伴教育者参与艾滋病毒披露过程的看法

"The Peer Educator Is the Game-Changer of My Life": Perceptions of Adolescents Living with HIV in DR Congo on Involving Peer Educators in the Process of HIV Disclosure.

作者信息

Kitetele Faustin Nd, Lelo Gilbert M, Akele Cathy E, Lelo Patricia V M, Mafuta Eric M, Tylleskär Thorkild, Kashala-Abotnes Espérance

机构信息

Department of Infectious Diseases, Kalembelembe Paediatric Hospital, Kinshasa 012, Democratic Republic of the Congo.

Centre for International Health (CIH), University of Bergen, 5020 Bergen, Norway.

出版信息

Children (Basel). 2022 Aug 17;9(8):1239. doi: 10.3390/children9081239.

Abstract

Several approaches to the disclosure of HIV status to children and adolescents have been described. Each of these places particular emphasis on the role of parents and health care workers (HCWs) to mitigate the impact of disclosure on the adolescent without exploring the possible roles that other individuals might play in the process of disclosure. This article assesses the perceptions of adolescents living with HIV (ALHIV) about disclosure done by parents, guardians, HCWs, peer educators in the role of peer supporters, accidentally or by self-discovery, and the subsequent effects of disclosure method on their mental health. We used a qualitative study to conduct semi-structured interviews with 73 ALHIV at the Kalembelembe Paediatric Hospital, in DR Congo disclosed to by parents, guardians, HCWs, and/or peer educators, respectively, or disclosed to accidentally or by self-discovery. Microsoft Excel analysis matrix was used to organize the qualitative data. The majority of ALHIV whose disclosure involved a peer educator unanimously acknowledged the important role of the peer in accepting their HIV status, in their ART adherence, and their development of self-esteem. However, most ALHIV disclosed without involving peers declared that they had accepted their situation after a relatively long period followed by contact with the peer and integration in the self-support group. We found that the peer approach is the game-changer of the HIV status disclosure process that would allow ALHIV to accept their HIV status with minimum distress, it builds resilience, and allows them to adhere to treatment.

摘要

已有多种向儿童和青少年披露艾滋病毒感染状况的方法被描述。这些方法中的每一种都特别强调父母和医护人员在减轻披露对青少年的影响方面所起的作用,而没有探讨其他个人在披露过程中可能发挥的作用。本文评估了感染艾滋病毒的青少年(ALHIV)对父母、监护人、医护人员、担任同伴支持者角色的同伴教育者、意外或自我发现进行的披露的看法,以及披露方式对他们心理健康的后续影响。我们采用定性研究方法,在刚果民主共和国的卡伦贝勒姆贝儿科医院对73名ALHIV进行了半结构化访谈,他们分别由父母、监护人、医护人员和/或同伴教育者披露感染状况,或者是意外或自我发现感染状况。使用微软Excel分析矩阵来整理定性数据。大多数通过同伴教育者披露感染状况的ALHIV一致认可同伴在接受他们的艾滋病毒感染状况、坚持抗逆转录病毒治疗以及自尊发展方面所起的重要作用。然而,大多数未通过同伴披露感染状况的ALHIV表示,在与同伴接触并融入自助小组后的一段较长时间里,他们才接受了自己的状况。我们发现,同伴方法是艾滋病毒感染状况披露过程中的变革因素,它能让ALHIV在最小的痛苦中接受自己的艾滋病毒感染状况,增强复原力,并使他们坚持治疗。

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