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在赞比亚的艾滋病毒服务提供中,影响医疗服务提供者与性少数男性之间沟通的因素。

Factors that influence communication between healthcare providers and sexual minority men in HIV service delivery in Zambia.

作者信息

Addo Prince Nii Ossah, Qiao Shan, Muttau Nobutu, Lwatula Clementina, Ngosa Levy, Kabwe McLean, Menon J Anitha, Brown Monique J, Li Xiaoming, Harper Gary W

机构信息

Department of Epidemiology and Biostatistics, University of South Carolina, Columbia, USA.

Department of Health Promotion Education and Behavior, University of South Carolina, Columbia, USA.

出版信息

AIDS Care. 2025 Jul;37(7):1140-1149. doi: 10.1080/09540121.2025.2487224. Epub 2025 Apr 15.


DOI:10.1080/09540121.2025.2487224
PMID:40233714
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12213162/
Abstract

Studies that have investigated client-provider interactions in HIV service delivery have focused mainly on the views of sexual and gender minorities. This study explored the views of both Healthcare Providers (HCPs) and Sexual Minority Men (SMM) in Zambia about factors that influence client-provider interactions and how this could affect HIV service delivery. We conducted in-depth interviews with 20 HCPs (>25 years old) and 20 SMM (20-34 years old) purposively recruited from Lusaka with help from local partners in 2021. Interviews lasted 30-80 min, were conducted in English, and were audio-recorded. Verbatim transcripts of audio files were iteratively coded using Nvivo. Thematic analysis was performed using the inductive approach. Study findings suggest that a lack of trust in HCPs among SMM and the religious and cultural persuasions of some HCPs negatively impact communication between SMM and HCPs. The above factors will likely make establishing a good working relationship between HCPs and SMM difficult and could negatively influence HIV service delivery. Therefore, promoting an SMM-friendly environment at health facilities and promoting HCPs' understanding of the health needs of SMM are critical to ensure the delivery of quality HIV services to SMM in Zambia.

摘要

在艾滋病毒服务提供过程中调查医患互动的研究主要集中在性少数群体和性别少数群体的观点上。本研究探讨了赞比亚医疗服务提供者(HCPs)和男同性恋者(SMM)对于影响医患互动的因素的看法,以及这如何影响艾滋病毒服务的提供。2021年,我们在当地合作伙伴的帮助下,从卢萨卡有目的地招募了20名医疗服务提供者(年龄>25岁)和20名男同性恋者(年龄20 - 34岁)进行深入访谈。访谈持续30 - 80分钟,用英语进行,并进行了录音。音频文件的逐字记录使用Nvivo进行迭代编码。采用归纳法进行主题分析。研究结果表明,男同性恋者对医疗服务提供者缺乏信任,以及一些医疗服务提供者的宗教和文化观念对男同性恋者与医疗服务提供者之间的沟通产生了负面影响。上述因素可能会使医疗服务提供者与男同性恋者之间难以建立良好的工作关系,并可能对艾滋病毒服务的提供产生负面影响。因此,在医疗机构营造一个对男同性恋者友好的环境,并促进医疗服务提供者对男同性恋者健康需求的理解,对于确保向赞比亚的男同性恋者提供高质量的艾滋病毒服务至关重要。

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本文引用的文献

[1]
"What if I get sick, where shall I go?": a qualitative investigation of healthcare engagement among young gay and bisexual men in Nairobi, Kenya.

BMC Public Health. 2024-1-2

[2]
Human Rights, Stigma, and Substance Use.

Health Hum Rights. 2020-6

[3]
Comparison of the prevalence rates of HIV infection between men who have sex with men (MSM) and men in the general population in sub-Saharan Africa: a systematic review and meta-analysis.

BMC Public Health. 2019-12-4

[4]
A Systematic Review of the Discrimination Against Sexual and Gender Minority in Health Care Settings.

Int J Health Serv. 2020-1

[5]
HIV care engagement and ART adherence among Kenyan gay, bisexual, and other men who have sex with men: a multi-level model informed by qualitative research.

AIDS Care. 2018-8

[6]
Quality of care and HIV service utilization among key populations in Zambia: a qualitative comparative analysis among female sex workers, men who have sex with men and people who use drugs.

AIDS Care. 2019-4

[7]
Disclosure of Same-Sex Behaviors to Health-care Providers and Uptake of HIV Testing for Men Who Have Sex With Men: A Systematic Review.

Am J Mens Health. 2018-9

[8]
Patient-Provider Communication Barriers and Facilitators to HIV and STI Preventive Services for Adolescent MSM.

AIDS Behav. 2018-10

[9]
Facilitators and barriers for HIV-testing in Zambia: A systematic review of multi-level factors.

PLoS One. 2018-2-7

[10]
Sexual orientation disclosure in health care: a systematic review.

Br J Gen Pract. 2018-1-29

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