全治疗时代的艾滋病病毒感染状况披露:坦桑尼亚欣扬加地区婚姻关系中社会期望与披露的复杂性。

IF 1.2 4区 医学 Q4 HEALTH POLICY & SERVICES
Tusajigwe Erio, Josien de Klerk, Eileen Moyer
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引用次数: 0

摘要

艾滋病病毒感染者(PLHIV)的临床治疗取得了长足的进步,形成了目前的 "治疗即预防 "策略:当检测不到病毒时,就不会传播病毒。尽管如此,在 "全治疗 "时代,婚姻关系中的信息披露对于坚持最佳治疗和进一步限制传播仍然非常重要。然而,披露可能会带来严重的社会影响,尤其是对女性而言。本文探讨了坦桑尼亚婚姻关系中的性别披露决定及其社会后果。通过在欣扬加地区进行的为期 9 个月的人种学研究,我们探讨了苏库马社会价值观是如何影响披露决定的。我们对 103 名艾滋病毒携带者进行了深入访谈,并开展了 19 次小组讨论。我们发现,有关性别和婚姻的社会价值观在很大程度上影响了在婚姻关系中披露信息的决定。艾滋病毒全治疗方法注重尽早开始治疗,以保持健康和无传播能力,这使得男性和女性能够仔细权衡披露信息对其婚姻愿望的成本和收益。抗逆转录病毒治疗对社会关系的益处往往在医疗干预中被忽视。我们的结论是,为了减少艾滋病毒感染者在做出披露决定时的困难,需要强调社区对艾滋病毒治疗作为预防措施的认识,以减轻披露带来的负面影响。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
HIV status disclosure in the era of treat-all: the complexities of societal expectations and disclosure in marital relationships in Shinyanga, Tanzania.

Robust advancements in clinical treatment of people living with HIV (PLHIV) have resulted in the current "treatment as prevention" strategy: the inability to transmit the virus when it is undetectable. Nevertheless, disclosure within marital relationships remains important to adhere optimally to treatment and further limit transmission in the era of treat-all. Disclosure, however, can have serious social repercussions, particularly for women. This paper examines gendered disclosure decisions and their social consequences in marital relationships in Tanzania. Drawing from a 9-month ethnographic study in Shinyanga Region, we explore how Sukuma societal values shape disclosure decisions. In-depth interviews with 103 PLHIV and 19 FGDs inform our analysis. We found that societal values regarding gender and marriage significantly influence disclosure decisions in marital relationships. The HIV treat-all approach, with its focus on early treatment initiation preserved health and inability to transmit allowed men and women to carefully weigh the costs and benefits of disclosure to their marital aspirations. The benefits of antiretroviral treatment for social relations are often overlooked in medical interventions. We conclude that to reduce difficult disclosure decisions for PLHIV, emphasising community awareness of HIV treatment as prevention to mitigate the negative impacts of disclosure is needed.

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