“告知还是不告知”:我国男同性恋HIV阳性者暴露现状和原因的质性研究

To Tell or Not to Tell:A Qualitative Study of Status and Causes of Homosexual Men's Disclosure the HIV-positive and Sexual Orientation to Others

目的:探讨男同性恋HIV阳性者暴露/不暴露HIV阳性状态/性取向的现状和原因。方法:采用质性研究方法,选取2009年3月—2010年3月于北京佑安医院就诊的37名男同性恋HIV阳性者,实施深入访谈,对访谈资料进行编码,提炼出概念类属。结果:37名被试中,有31名向不同的对象暴露了自己HIV阳性状态/性取向的状况。选择暴露的原因主要有"责任"、"安全"、"获得支持"、"缓解结婚压力";不暴露的原因主要有"担心家人无法接受"、"不想给家人增加压力"、"愧疚感"、"担心受歧视"。结论:医疗或相关心理从业者应考虑男同性恋HIV阳性者的双重身份,结合中国社会文化特点提供恰当的心理干预措施。

Objective： To explore the status and causes of HIV positive gay men＇s disclosure of their HIV-positive status and sexual orientation to their parents, intimate partners and close friends. Methods： Individual in-depth interviews with semi-structure interview guide were conducted in 37 HIV-positive gay men （aged 23-42 years） who received treat- ment in Beijing You ＇an Hospital（from March, 2009 to March, 2010）. Qualitative methods were used in analyzing interview recordings and notes. Results： There were 31 participants who disclosed their HIV-positive status and sexual orientation to others. The reasons for disclosure were due to ＂responsibility ＂, ＂ensuring the security of their partners＂, ＂concurrent need for support＂ and ＂relieving the pressure of getting married＂; on the other hand, reasons of not telling were because of ＂threat of stigma＂, ＂feelings of shame＂, ＂pressures on family members＂. Conclusion： When providing psychological assistance to HIV-positive gay men, medical doctors and psychologists should take their special identifies in context of the Chinese culture and traditions into consideration.