奈及利亞東南部埃努古州年輕愛滋感染者的社會心理健康：質性探勘研究

Abstract

By 2030, Nigeria expects to achieve one of the ambitious targets set by the Joint United Nations Programme on HIV and AIDS (UNAIDS), namely, 95% of the country’s people living with HIV, receiving treatment, and suppressing viral load. National efforts to strategize toward this ambitious goal have been underway since the turn of the 21st century. One vital aspect of such coordinated efforts has, however, remained ignored: the psychosocial health of young seropositive people. As one of the “higher HIV burden states” in the country, Enugu state in southeast Nigeria has an HIV prevalence rate of 1.9%—higher than 1.3%, the national average. A significant proportion of this population (15-49 years) has suffered interruptions in treatment at least once in the last two years (either as missed appointments or loss-to-follow-up patients). These people’s clinical disruption is related to their worsening mental health and even suicidal ideation. A qualitative study has thus been conducted, including focus group discussions and in-depth interviews with 20 young people living with HIV (YPLHIV, aged 20-30 years) in the state from four different health facilities. The interviews focused on their emotional and mental health, their coping strategies in managing the factors that affect their lives, and strategies to recall and retain all YPLHIV with suicidal ideations back to care. Interviews were also conducted with the antiretroviral-providing clinicians across four health facilities to explore health providers’ observations and perspectives on YPLHIV. The study finds that HIV-related stigma contributes to their suffering, resulting in self and social isolation, inability to develop intimate relationships, clinical abuse, and financial and nutritional stressors leading to virologic failure. However, interestingly, the shared experience of stigmatization has also motivated their resilience in the face of clinical angsts. The “sero-kinship”, a web of social relationships between YPLHIV, has connected and supported them in navigating their treatment regimens. Therefore, I argue that, in addition to de-stigmatization and provision of care that is not biomedically focused, it is also important to recognize and strengthen the burgeoning sero-kinship between persons living with HIV, who share almost identical clinical experience and sense of survival—not only for medication maintenance but also for mental health promotion.