"It's When the Trees Blossom": Explanatory Beliefs, Stigma, and Mental Illness in the Context of HIV in Botswana

被引：20

作者：

Becker, Timothy D. ^{[1
]}

Ho-Foster, Ari R. ^{[1
,5
]}

Poku, Ohemaa B. ^{[6
]}

Marobela, Shathani ^{[7
]}

Mehta, Haitisha ^{[8
]}

Cao, Dai Thi Xuan ^{[9
]}

Yang, Lyla S. ^{[10
]}

Blank, Lilo, I ^{[12
]}

Dipatane, Vincent Ikageng ^{[13
,14
]}

Moeng, Letumile Rogers ^{[13
,14
]}

Molebatsi, Keneilwe ^{[15
]}

Eisenberg, Marlene M. ^{[2
]}

Barg, Frances K. ^{[3
]}

Blank, Michael B. ^{[4
]}

Opondo, Philip Renison ^{[1
,15
]}

Yang, Lawrence H. ^{[11
,16
]}

机构：

[1] Univ Penn, Philadelphia, PA 19104 USA

[2] Univ Penn, Dept Psychiat, HIV AIDS Prevent Res Div, Philadelphia, PA 19104 USA

[3] Univ Penn, Perelman Sch Med, Fac Med & Commun Hlth, Philadelphia, PA 19104 USA

[4] Univ Penn, Perelman Sch Med, Psychol Psychiat, HIV AIDS Prevent Res Div, Philadelphia, PA 19104 USA

[5] Botswana UPenn Partnership, Gaborone, Botswana

[6] Boston Univ, Bloomberg Sch Publ Hlth, Dept Mental Hlth, Boston, MA 02215 USA

[7] Univ Botswana, Dept Psychol, Gaborone, Botswana

[8] Columbia Univ, Teachers Coll, New York, NY 10027 USA

[9] Columbia Univ, New York, NY 10027 USA

[10] Columbia Univ, Sch Social Work, New York, NY 10027 USA

[11] Columbia Univ, Epidemiol, New York, NY 10027 USA

[12] Univ Rochester, Rochester, NY USA

[13] Princess Marina Hosp, Infect Dis Care Clin, Gaborone, Botswana

[14] Botswana Minist Hlth & Wellness, Gaborone, Botswana

[15] Univ Botswana, Sch Med, Gaborone, Botswana

[16] NYU, Global Mental Hlth & Stigma Program, Coll Global Publ Hlth, New York, NY USA

来源：

QUALITATIVE HEALTH RESEARCH | 2019年 / 29卷 / 11期

关键词：

explanatory models; stigma; syndemic; mental illness; Botswana; qualitative; AIDS-RELATED STIGMA; ANTIRETROVIRAL THERAPY; 1ST-EPISODE PSYCHOSIS; SEEKING BEHAVIOR; PUBLIC-HEALTH; HELP-SEEKING; CARE; SCHIZOPHRENIA; MODELS; DISORDERS;

D O I：

10.1177/1049732319827523

中图分类号：

R1 [预防医学、卫生学];

学科分类号：

1004 ; 120402 ;

摘要：

Mental illness is a common comorbidity of HIV and complicates treatment. In Botswana, stigma impedes treatment of mental illness. We examined explanatory beliefs about mental illness, stigma, and interactions between HIV and mental illness among 42 adults, from HIV clinic and community settings, via thematic analysis of interviews. Respondents endorse witchcraft as a predominant causal belief, in addition to drug abuse and effects of HIV. Respondents describe mental illness as occurring "when the trees blossom," underscoring a conceptualization of it as seasonal, chronic, and often incurable and as worse than HIV. Consequently, people experiencing mental illness (PEMI) are stereotyped as dangerous, untrustworthy, and cognitively impaired and discriminated against in the workplace, relationships, and sexually, increasing vulnerability to HIV. Clinical services that address local beliefs and unique vulnerabilities of PEMI to HIV, integration with peer support and traditional healers, and rehabilitation may best address the syndemic by facilitating culturally consistent recovery-oriented care.

引用

页码：1566 / 1580

页数：15

共 68 条

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