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俄罗斯 HIV 护理不依从男男性行为者中的污名、血清学检测结果告知、应对策略,以及社会资本资源的作用:一项定性分析。

Stigma, serostatus disclosure, coping strategies, and the role of social capital resources among HIV care-nonadherent MSM in Russia: a qualitative analysis.

机构信息

Center for AIDS Intervention Research (CAIR), Medical College of Wisconsin, Milwaukee, WI, USA.

Interdisciplinary Center for AIDS Research and Training (ICART), St. Petersburg, Russia.

出版信息

AIDS Care. 2024 Jul;36(sup1):117-125. doi: 10.1080/09540121.2024.2305785. Epub 2024 Jan 30.

Abstract

The HIV epidemic continues to expand in Russia, with suboptimal levels of care uptake. This qualitative study aimed to characterize social capital resources and lived stigma experiences, coping, and disclosure among care-nonadherent men who have sex with men (MSM) living with HIV in Russia. Twenty-five HIV-positive MSM - recruited online - completed in-depth interviews over Zoom, with data analyzed using MAXQDA software. Stigma was more likely to be encountered in interactions with persons with whom social ties were weaker such as medical providers and relatives, particularly males. Close friends - often other HIV-positive MSM and female relatives - were the most supportive and least stigmatizing. Similar persons were most often considered for HIV serostatus disclosure. Coping strategies to reduce the impact of stigma included ignoring stigmatizing experiences, seeking support from members of one's social circle, minimizing contact with stigmatizing persons, seeking new relationships with persons who are also HIV-positive, proactively reducing stigma through involvement in advocacy roles, and correcting myths and educating others about HIV infection. These findings underscore the need for interventions to assist HIV-positive MSM in building accepting social capital resources to reduce the impact of stigma and to build support within their social networks, often with other HIV-positive MSM.

摘要

俄罗斯的艾滋病毒疫情继续蔓延,医疗服务的接受程度并不理想。本定性研究旨在描述俄罗斯艾滋病毒阳性的男男性行为者(MSM)中不依从护理者的社会资本资源和经历的污名化体验、应对策略和披露情况。25 名艾滋病毒阳性的 MSM 通过在线招募完成了 Zoom 上的深度访谈,使用 MAXQDA 软件对数据进行了分析。在与社会关系较弱的人(如医疗服务提供者和亲属)的互动中,污名化更有可能发生,尤其是男性。亲密的朋友——通常是其他艾滋病毒阳性的 MSM 和女性亲属——是最支持和最少污名化的。通常会考虑与具有相似经历的人披露艾滋病毒血清阳性状态。减少污名化影响的应对策略包括忽略污名化的经历、从社交圈成员那里寻求支持、尽量减少与污名化的人的接触、与同样艾滋病毒阳性的人建立新的关系、通过参与倡导角色主动减少污名化,并纠正有关艾滋病毒感染的误解和教育他人。这些发现强调需要干预措施,帮助艾滋病毒阳性的 MSM 建立可接受的社会资本资源,以减少污名化的影响,并在其社交网络中建立支持,通常是与其他艾滋病毒阳性的 MSM。

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