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从 HIV 到猴痘:巴西性少数群体中的传染病、污名化和病理化的社会话语分析。

From HIV to Mpox: Socio-discursive Analysis of Communicable Diseases, Stigma, and Pathologization in Sexual Minorities in Brazil.

机构信息

Graduate Program in Nursing, College of Nursing, Federal University of Ceará, Rua Alexandre Baraúna, 1115, Rodolfo Teófilo/Fortaleza, CE, CEP 60430-160, Brazil.

Graduate Program in Nursing, University of International Integration of Afro-Brazilian Lusophony, Redenção, Ceará, Brazil.

出版信息

Arch Sex Behav. 2024 Nov;53(10):3809-3824. doi: 10.1007/s10508-024-02968-5. Epub 2024 Sep 3.

Abstract

Discrimination and stigma are significant barriers to healthcare for the LGBTQIAPN+ community, necessitating a deeper analysis of their sociocultural causes. There is a notable gap in the literature regarding the understanding of socio-discursive representations and their impact on the stigmatization and pathologization of sexual minorities in the context of communicable diseases. This study aims to discuss the understanding of the sociodiscursive aspects of the health-disease process, particularly in stigmatized infectious diseases affecting the LGBTQIAPN+ community. The focus is on examining how news articles, or the set of analyzed texts (corpus), shape these perceptions. We conducted documentary research with a qualitative and discursive approach using news articles retrieved from Google News about diseases affecting the LGBTQIAPN+ population from 2011 to 2022. The analysis was based on critical discourse analysis, processed using MAXQDA and IRAMUTEQ software. The identified representations predominantly align with biomedical ideology, manifesting in a discourse that normalizes and medicalizes (normative-curative discourse), and notable for its pathologizing and stigmatizing nature. Six classes were found: Ethical professional dilemmas facing stigma, infection and contamination of the LGBT+ population, prejudice and discrimination in the form of information, stigma related to sexual behavior/orientation, Vulnerability and stigma related to infectious diseases, and strategies for minimizing health risk/stigma for the LGBT+ public. The most relevant analytical categories were related to infectious diseases and sexual identity. These themes were identified, indicating that media representations reinforce stigma and maintain unequal health practices (verticalization) for the LGBT+ community. Understanding these patterns within a broader historical context is crucial for promoting health education and strategies that challenge internalized prejudice. The need to reformulate cultural norms and develop health information and education policies is urgent. These policies should be led by professionals with a comprehensive and humanized vision, addressing the diverse needs of the LGBT+ population.

摘要

歧视和污名化是 LGBTQIAPN+ 群体获得医疗保健的重大障碍,因此需要深入分析其社会文化原因。在理解社会话语表现及其对传染病背景下性少数群体污名化和病理化的影响方面,文献中存在明显的差距。本研究旨在讨论对健康-疾病过程中社会话语方面的理解,特别是在影响 LGBTQIAPN+ 群体的污名化传染病方面。重点是研究新闻文章(或分析文本集)如何塑造这些观念。我们进行了文献研究,采用了定性和话语方法,使用了从 Google News 检索到的关于 2011 年至 2022 年影响 LGBTQIAPN+ 人群的疾病的新闻文章。分析基于批评话语分析,使用 MAXQDA 和 IRAMUTEQ 软件进行处理。确定的代表性观点主要与生物医学意识形态一致,表现为一种将性少数群体正常化和医学化的话语(规范-治疗话语),其特点是病理化和污名化。发现了六个类别:面对污名的伦理专业困境、LGBT+ 人群的感染和污染、以信息形式出现的偏见和歧视、与性行为/取向相关的污名、与传染病相关的脆弱性和污名、以及最小化 LGBT+ 公众健康风险/污名的策略。最相关的分析类别与传染病和性身份有关。这些主题的确定表明,媒体的代表性强化了污名化,并维持了对 LGBT+ 群体不平等的健康实践(垂直化)。在更广泛的历史背景下理解这些模式对于促进健康教育和挑战内化偏见的策略至关重要。迫切需要重新制定文化规范,制定卫生信息和教育政策。这些政策应由具有全面和人性化视野的专业人员领导,满足 LGBT+ 群体的多样化需求。

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