Fauk Nelsensius Klau, Asa Gregorius Abanit, McLean Caitlan, Ward Paul Russell
Centre for Public Health, Equity and Human Flourishing, Torrens University Australia, 88 Wakefield St., Adelaide, SA 5000, Australia.
Institute of Resource Governance and Social Change, Kupang 85227, Nusa Tenggara Timur, Indonesia.
Int J Environ Res Public Health. 2023 Dec 20;21(1):9. doi: 10.3390/ijerph21010009.
HIV diagnosis and poor HIV management have various detrimental impacts on the lives of people living with HIV (PLHIV). As a part of a large qualitative study investigating HIV risk factors and impacts, of which the topic of suicide is not a focus, this paper describes the factors contributing to suicidal ideation and attempts that arose naturally in the stories of women living with HIV (WLHIV; = 52) in Yogyakarta and Belu districts, Indonesia. The participants were recruited using the snowball sampling technique. Guided by a qualitative data analysis framework, the data were thematically analysed. The findings were grouped into four main themes: (i) the women experienced immense psychological challenges due to the infection, spousal transmission, fear of mother-to-child transmission, and losing a child due to AIDS, which triggered suicidal ideation and attempts; (ii) the lack of awareness of HIV management strategies resulted in them feeling trapped and overwhelmed, and the associated negative thoughts and the anticipation and experience of HIV stigma influenced their thoughts of suicide; (iii) the lack of social support from family and friends during the early stages of HIV diagnosis, compounded with pre-existing financial difficulties, lack of income, unemployment, and feeling overburdened, also triggered the women's thoughts of suicide; and (iv) family breakdown following HIV diagnosis, concern about future relationships, and fear of being rejected or abandoned by their partner were also influencing factors for suicidal ideation and attempts among the women. The findings indicate the need for a nuanced approach to counselling within HIV care interventions for couples to support the acceptance of each other's HIV status whilst maintaining psychological wellbeing. Additionally, the findings indicate the importance of HIV education and awareness among community members for the de-stigmatisation of HIV and to increase the acceptance of PLHIV by their families and communities.
艾滋病毒诊断及糟糕的艾滋病毒管理对艾滋病毒感染者的生活有着各种不利影响。作为一项调查艾滋病毒风险因素及影响的大型定性研究的一部分（该研究不以自杀为重点主题），本文描述了印度尼西亚日惹和贝利地区感染艾滋病毒的女性（52名感染艾滋病毒的女性）故事中自然出现的导致自杀意念和自杀未遂的因素。采用滚雪球抽样技术招募参与者。在定性数据分析框架的指导下，对数据进行了主题分析。研究结果分为四个主要主题：（i）这些女性因感染、配偶传播、对母婴传播的恐惧以及因艾滋病失去孩子而经历了巨大的心理挑战，这引发了自杀意念和自杀未遂行为；（ii）对艾滋病毒管理策略缺乏认识导致她们感到陷入困境且不堪重负，相关的消极想法以及对艾滋病毒污名的预期和经历影响了她们的自杀念头；（iii）在艾滋病毒诊断初期缺乏家人和朋友的社会支持，再加上原有的经济困难、收入不足、失业以及感到负担过重，也引发了这些女性的自杀念头；（iv）艾滋病毒诊断后家庭破裂、对未来关系的担忧以及害怕被伴侣拒绝或抛弃也是这些女性自杀意念和自杀未遂行为的影响因素。研究结果表明，在针对夫妻的艾滋病毒护理干预中，需要采取细致入微的咨询方法，以支持双方接受彼此的艾滋病毒感染状况，同时维持心理健康。此外，研究结果表明，社区成员进行艾滋病毒教育和提高认识对于消除对艾滋病毒的污名化以及增加家庭和社区对艾滋病毒感染者的接纳至关重要。
