Zamora-Moncayo Emilia C, Herrera-Díaz Bernarda, Camacho Juan Francisco, Jiménez Alexia, Brown Ser, Troya Valeria
Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada.
Centro de Salud Mental, Universidad San Francisco de QuitoUSFQ, Quito, Ecuador.
Qual Health Res. 2024 Nov 17;35(10-11):10497323241292279. doi: 10.1177/10497323241292279.
People living with HIV (PLHIV) in Ecuador experience challenges including discrimination, violence, and limited access to healthcare, which impacts their mental health and well-being. However, research shows that PLHIV also rely on social resources to foster resilience. In the Ecuadorian context, there is no literature exploring these narratives, which results in a lack of qualitative data to improve the reality of PLHIV in the country. To gain a deeper understanding of these stories, 15 semi-structured interviews were undertaken (15 verbatim hours) within the context of a peer- and professional-led support group for PLHIV and were analyzed through a thematic approach based on Skovdal and Daniel's conceptual framework on resilience and adversity. Findings suggest that PLHIV face multifaceted challenges across the home, community, and political-economy spheres. Families and communities can elicit pain and fear, leading individuals to avoid discussing their diagnosis due to ongoing rejection. Further, discrimination perpetuated within the public health sector, as well as societal violence, exacerbates adversity. Nevertheless, participants stress the indispensable role of family support, community networks, and accessible healthcare in fostering resilience. Specifically, support, emotional reassurance, and willingness to learn enabled PLHIV to build resilience. These findings emphasize the need for approaches that counter discrimination, enhance well-being, ensure integral and intersectional healthcare access, and promote knowledge around HIV.
厄瓜多尔的艾滋病毒感染者面临着诸多挑战，包括歧视、暴力以及获得医疗保健的机会有限，这些都影响着他们的心理健康和幸福。然而，研究表明，艾滋病毒感染者也依赖社会资源来增强复原力。在厄瓜多尔的背景下，尚无文献探讨这些经历，这导致缺乏定性数据来改善该国艾滋病毒感染者的现状。为了更深入地了解这些故事，在一个由同伴和专业人员主导的艾滋病毒感染者支持小组的背景下进行了15次半结构化访谈（共15个逐字记录小时），并根据斯科夫达尔和丹尼尔关于复原力与逆境的概念框架，通过主题方法进行了分析。研究结果表明，艾滋病毒感染者在家庭、社区和政治经济领域面临多方面的挑战。家庭和社区可能引发痛苦和恐惧，导致个人因持续的排斥而避免谈论自己的诊断。此外，公共卫生部门长期存在的歧视以及社会暴力加剧了逆境。尽管如此，参与者强调家庭支持、社区网络和可及的医疗保健在增强复原力方面不可或缺的作用。具体而言，支持、情感安慰和学习意愿使艾滋病毒感染者能够建立复原力。这些研究结果强调了采取措施应对歧视、增进福祉、确保全面和交叉的医疗保健机会以及促进有关艾滋病毒的知识的必要性。
