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Using systems thinking to leverage adolescent sexual and reproductive health in rural Latino communities. 在拉丁裔农村社区运用系统思维,促进青少年的性健康和生殖健康。
IF 1.8 3区 医学 Q2 FAMILY STUDIES Pub Date : 2024-11-14 DOI: 10.1080/13691058.2024.2427127
Amanda Mazur, Nancy F Berglas, Martha J Decker

Disparities in adolescent sexual and reproductive health (SRH) outcomes in rural areas of the USA persist as a concern in achieving health equity for youth. A growing body of literature recognises that improving adolescents' health necessitates systems thinking to address the culture and environment in which adolescents live. This paper uses systems thinking to identify leverage points to improve adolescent SRH in rural Latino communities in California. We conducted focus group discussions with 22 young people and interviewed 10 adult stakeholders to centre the perspectives of youth and youth-serving professionals. Transcripts were coded and analysed using systems thinking. Five themes were developed: (1) community and cultural norms can be a source of both support and stigma for youth; (2) families are key to supporting health education and services; (3) rural schools provide a central hub for programme delivery; (4) community-based organisations can work to serve rural youth, but limited resources and transport are challenges; and (5) youth face considerable barriers accessing SRH services in their communities. Using systems thinking to identify leverage points and gaps in interactions between system components influencing youth can aid in the development of more holistic and culturally responsive approaches for rural youth SRH.

美国农村地区青少年性与生殖健康(SRH)结果的差异一直是实现青少年健康公平的一个问题。越来越多的文献认识到,要改善青少年的健康状况,就必须采用系统思维来解决青少年所处的文化和环境问题。本文运用系统思维来确定改善加利福尼亚州农村拉丁裔社区青少年性健康和生殖健康的杠杆点。我们与 22 名青少年进行了焦点小组讨论,并采访了 10 名成年利益相关者,以了解青少年和青少年服务专业人员的观点。我们运用系统思维对讨论记录进行了编码和分析。形成了五个主题:(1) 社区和文化规范既可以成为支持青少年的源泉,也可以成为羞辱青少年的源泉;(2) 家庭是支持健康教育和服务的关键;(3) 农村学校是计划实施的中心枢纽;(4) 社区组织可以努力为农村青少年提供服务,但有限的资源和交通是挑战;(5) 青少年在其社区获得性健康和生殖健康服务面临着相当大的障碍。利用系统思维来确定影响青年的系统组成部分之间相互作用的杠杆点和差距,有助于为农村青年性健康和生殖健康制定更全面、更符合文化需求的方法。
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引用次数: 0
Rapping about pleasure: the role of Black women's rap music in shaping Black women's sexual attitudes. Rapping about pleasure: the role of Black women's rap music in shaping Black women's sexual attitudes.
IF 1.8 3区 医学 Q2 FAMILY STUDIES Pub Date : 2024-11-12 DOI: 10.1080/13691058.2024.2424228
Andrea A Lewis

Black women's sexuality has historically been constrained by stereotypes and a discourse focused on risks rather than pleasure. Early Black women rappers initiated vital conversations about sexual pleasure, with contemporary Black women rappers continuing to challenge norms and define Black women's sexualities. Grounded in Hip-Hop Feminism and Sexual Script Theory, this study explores how Black women interpret and find meaning in sexual pleasure-focused lyrics in Black women's rap music and how these interpretations shape their sexual self-concepts and navigation of systemic oppression. Through semi-structured interviews with 20 Black women aged 20-42 years who frequently listen to Black women rappers, thematic and discourse analysis identified three key themes: (a) prioritising sexual pleasure as a means of self-empowerment; (b) practising assertiveness as a means to achieving sexual pleasure; and (c) celebrating the body as an act of sexual pleasure. Black women rappers' unapologetic discussion of sexual pleasure empowers Black women to reclaim sexuality on their own terms, independent of dominant societal narratives. This study extends existing literature on Hip-Hop Feminism by demonstrating the transformative potential of culturally relevant media in fostering sex-positive attitudes and advocates for incorporating these messages into sexual health education for Black women.

黑人女性的性行为历来受到陈规陋习的束缚,话语的重点在于风险而非快感。早期的黑人女说唱歌手发起了关于性快感的重要对话,当代黑人女说唱歌手继续挑战规范并定义黑人女性的性。本研究以 Hip-Hop 女性主义和性脚本理论为基础,探讨黑人女性如何解读黑人女性说唱音乐中注重性快感的歌词并从中找到意义,以及这些解读如何塑造她们的性自我概念和对系统压迫的驾驭。通过对 20 名经常聆听黑人女性说唱歌手演唱的 20-42 岁黑人女性进行半结构式访谈,主题分析和话语分析确定了三个关键主题:(a)将性快感作为自我赋权的一种手段;(b)将自信作为实现性快感的一种手段;以及(c)将赞美身体作为性快感的一种行为。黑人女性饶舌歌手对性快感的毫无保留的讨论赋予了黑人女性独立于主流社会叙事之外,根据自身条件重新获得性的能力。本研究扩展了现有的嘻哈女权主义文献,展示了与文化相关的媒体在培养积极的性态度方面的变革潜力,并倡导将这些信息纳入黑人女性的性健康教育中。
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引用次数: 0
Cultural taboos and low sexual and reproductive health literacy among university students in Magway city, Myanmar. 缅甸马圭市大学生的文化禁忌与性健康和生殖健康知识水平低下。
IF 1.8 3区 医学 Q2 FAMILY STUDIES Pub Date : 2024-11-02 DOI: 10.1080/13691058.2024.2420704
Hnin Aye Kyu, Rassamee Chotipanvithayakul, Edward Braddon McNeil, Nyan Lin Thu

University students in Myanmar experience a high prevalence of sexual and reproductive health (SRH) problems including unintended pregnancies and sexually transmitted infections. These are compounded by pervasive cultural taboos surrounding sex and sexuality. Sexual and reproductive health literacy is crucial to addressing these problems. Four focus group discussions with 33 university students revealed how cultural taboos act as barriers across five SRH literacy subdomains: accessing, comprehending, criticising and applying SRH information, and communicating with healthcare providers. Students primarily relied on online health information rather than face-to-face discussions. Many students considered SRH information to be 'dirty' and experienced feelings of shame, guilt and fear of being blamed or disrespected while seeking healthcare. They therefore hesitated to visit healthcare providers and sought SRH services only in urgent medical situations. Additionally, all SRH literacy subdomains were influenced by cultural taboos surrounding sex: societal denial towards youth premarital sex, and the perception of sexual matters as embarrassing and inappropriate. Advocacy is needed to promote positive societal attitudes towards sexual matters and youth premarital sex, signalling the value of culturally tailored digital SRH literacy interventions using vernacular language. Healthcare providers should offer non-judgemental youth-centred services to promote SRH literacy among students.

缅甸大学生的性健康和生殖健康(SRH)问题非常普遍,包括意外怀孕和性传播感染。而围绕性和性的文化禁忌又使这些问题更加严重。性与生殖健康知识的普及对于解决这些问题至关重要。与 33 名大学生进行的四次焦点小组讨论揭示了文化禁忌是如何成为五个性与生殖健康素养子领域的障碍的:获取、理解、批评和应用性与生殖健康信息,以及与医疗保健提供者沟通。学生们主要依靠在线健康信息,而不是面对面的讨论。许多学生认为性健康和生殖健康信息是 "肮脏的",在寻求医疗保健服务时会感到羞耻、内疚,害怕受到指责或不尊重。因此,他们对去医疗机构就诊犹豫不决,只有在紧急医疗情况下才寻求性健康和生殖健康服务。此外,所有性健康和生殖健康素养分领域都受到围绕性的文化禁忌的影响:社会对青年婚前性行为的否认,以及认为性问题是令人尴尬和不恰当的。有必要进行宣传,以促进社会对性问题和青年婚前性行为的积极态度,这也表明了使用本地语言进行符合文化特点的数字性健康和生殖健康扫盲干预的价值。医疗保健提供者应提供以青年为中心的非评判性服务,以促进学生对性健康和生殖健康的认识。
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引用次数: 0
Girls' experiences of cellphone porn use in South Africa and their accounts of sexual risk in the classroom. 南非女孩使用手机看色情片的经历及其对课堂上性风险的描述。
IF 1.8 3区 医学 Q2 FAMILY STUDIES Pub Date : 2024-11-01 Epub Date: 2024-03-13 DOI: 10.1080/13691058.2024.2326846
Emmanuel Mayeza, Ndumiso Daluxolo Ngidi, Deevia Bhana, Raksha Janak

Violence remains a persistent challenge in South African schools, prompting investigations into underlying risk factors and mitigation strategies. However, an under-explored aspect of this violence is the potential link between the consumption of Internet porn via cellphones among girls and boys, and girls' risks to sexual violence inside the classroom. To address this gap, we used focus group discussions with 14-17-year-old South African girls to examine their experiences of porn access via cellphones and their accounts of sexual violence at school. The study illuminates the nuanced ways in which the girls experience risks and express agency. First, the girls illustrate a link between sexual harassment and boys accessing porn on their cellphones during class. Second, the findings show how girls negotiate their sexual agency and safety through contesting sexual violence. Third, there are conflicting views about porn: while some girls admitted liking and viewing porn, others objected to it as harmful and degrading. Finally, this study offers crucial insights into strategies to create safer school environments and gender equality by drawing attention to the intersections between cellphone porn consumption, sexuality, and girls' negotiations of sexual agency amidst sexual risk in the classroom.

在南非的学校中,暴力仍然是一个长期存在的挑战,促使人们对潜在的风险因素和缓解策略进行调查。然而,这种暴力的一个未被充分探讨的方面是,男女生通过手机消费网络色情与女生在课堂上遭受性暴力的风险之间的潜在联系。为了填补这一空白,我们与 14-17 岁的南非女孩进行了焦点小组讨论,研究她们通过手机获取色情内容的经历以及她们对校园性暴力的描述。这项研究揭示了女孩们体验风险和表达能动性的细微方式。首先,女孩们说明了性骚扰与男孩在上课期间通过手机获取色情内容之间的联系。其次,研究结果表明了女孩如何通过与性暴力抗争来协商她们的性代理权和安全。第三,对色情的看法存在冲突:一些女孩承认喜欢并观看色情,而另一些女孩则反对色情,认为色情有害且有辱人格。最后,本研究通过关注手机色情消费、性行为以及女孩在课堂性风险中对性能动性的协商之间的交叉关系,为创造更安全的学校环境和性别平等战略提供了重要见解。
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引用次数: 0
Healthcare professionals' attitudes towards the termination of pregnancy: a qualitative analysis of survey data in Northern Ireland. 医护人员对终止妊娠的态度:北爱尔兰调查数据的定性分析。
IF 1.8 3区 医学 Q2 FAMILY STUDIES Pub Date : 2024-11-01 Epub Date: 2024-03-13 DOI: 10.1080/13691058.2024.2324004
Nóirín MacNamara, Fiona Bloomer, Leanne Morgan, Ralph Roberts

Abortion was decriminalised in Northern Ireland in October 2019. Following decriminalisation, the new regulations set out legal provision for abortion up until 12 weeks, with conditions thereafter. This cross-sectional descriptive survey, conducted in late 2019 in Northern Ireland, gathered the views of health professionals on decriminalisation, and their willingness to provide abortion services. This article provides a thematic analysis of answers to narrative questions from the online survey, and identifies priority areas of engagement with healthcare professionals. We assess how healthcare professional roles and responsibilities, abortion procedures, the foetus, and women and pregnant people were discursively constructed by respondents who are willing or unwilling to provide abortion services in Northern Ireland. We identify a narrow understanding of 'harm', and gendered norms of women as irresponsible or duplicitous, as inhibitory factors to the normalisation of abortion services in Northern Ireland.

北爱尔兰于 2019 年 10 月将堕胎非刑罪化。非刑罪化后,新法规对 12 周内的堕胎做出了法律规定,并对之后的堕胎附加了条件。这项横断面描述性调查于 2019 年底在北爱尔兰进行,收集了医疗专业人员对非刑罪化的看法,以及他们提供堕胎服务的意愿。本文对在线调查中叙述性问题的答案进行了专题分析,并确定了与医护专业人员接触的优先领域。我们评估了愿意或不愿意在北爱尔兰提供堕胎服务的受访者是如何对医疗保健专业人员的角色和责任、堕胎程序、胎儿以及妇女和孕妇进行话语建构的。我们发现,对 "伤害 "的狭隘理解,以及将妇女视为不负责任或两面派的性别规范,是北爱尔兰堕胎服务正常化的阻碍因素。
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引用次数: 0
'You are looked upon as a luxury tool': Young Tanzanian women's perception of community norms supporting partner violence during transactional sex (kudanga). 你被视为奢侈的工具":坦桑尼亚年轻女性对支持性交易(kudanga)过程中伴侣暴力的社区规范的看法。
IF 1.8 3区 医学 Q2 FAMILY STUDIES Pub Date : 2024-11-01 Epub Date: 2024-04-26 DOI: 10.1080/13691058.2024.2339280
Kate Rogers, Lusajo Kajula, Mrema Noel Kilonzo, Tia Palermo, Meghna Ranganathan, R Lorraine Collins, Jennifer A Livingston, Thespina Yamanis

This paper explores the definition of, and perceived community attitudes, toward kudanga, a Swahili street term for a type of transactional sex practised in Dar es Salaam, Tanzania. Rooted in economic and gender disparity, transactional sex increases adolescent girls' and young women's vulnerability to HIV and gender-based violence. We sought to understand perceived community attitudes about kudanga, and how the internalisation of norms surrounding gender-based violence relate to the experiences of young women who practise kudanga. Using qualitative data from focus group discussions with 37 young women, we found that community perceptions of kudanga were largely negative, and those who engaged in it were looked down upon and despised. Violence and lack of sexual agency were normalised when doing kudanga. However, young women understood kudanga to often be their best option to obtain economic stability and felt strongly that those who practised kudanga should not be stigmatised. Our research provides further evidence that transactional sex exists on a continuum and highlights the importance of reducing community stigma surrounding transactional sex as a means of decreasing risk of HIV and gender-based violence for young women. To our knowledge, this article is the first to explore kudanga.

kudanga 是坦桑尼亚达累斯萨拉姆的一个斯瓦希里语街头用语,指的是一种性交易行为。性交易源于经济和性别差异,增加了少女和年轻女性感染艾滋病毒和遭受性别暴力的风险。我们试图了解社区对 kudanga 的看法,以及性别暴力规范的内化与从事 kudanga 的年轻女性的经历之间的关系。通过与 37 名年轻女性进行焦点小组讨论所获得的定性数据,我们发现社区对 kudanga 的看法大多是负面的,那些从事 kudanga 的人受到轻视和鄙视。在进行 kudanga 时,暴力和缺乏性能力被视为正常现象。然而,年轻女性认为库丹加往往是她们获得经济稳定的最佳选择,并强烈认为那些从事库丹加的人不应该被污名化。我们的研究进一步证明,性交易是一个连续的过程,并强调了减少社区对性交易的污名化的重要性,以此来降低年轻女性感染艾滋病毒和遭受性别暴力的风险。据我们所知,本文是第一篇探讨 kudanga 的文章。
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引用次数: 0
The ongoing and contentious coverage of abortion in a progressive context: a long-term cross-outlet assessment of Dutch abortion news (2000-2022). 在进步背景下对堕胎问题的持续和有争议的报道:对荷兰堕胎新闻(2000-2022 年)的长期跨媒体评估。
IF 1.8 3区 医学 Q2 FAMILY STUDIES Pub Date : 2024-11-01 DOI: 10.1080/13691058.2024.2408342
Annick C van Brouwershaven, Sophie H Bolt, Jeroen G F Jonkman

Utilising automated content analysis with transformer-based topic modelling (BERTopic), this study examines cross-outlet variation in volume and topics over two decades (2000-2022) of abortion coverage in seven major daily newspapers in the Netherlands. Our findings reveal an ongoing coverage of abortion. Volume of coverage was notably highest in religious newspapers, indicating that these newspapers constitute a prominent voice in Dutch abortion debate. We discerned four distinct frames used in abortion news coverage. The first emphasised political developments as well as protest and advocacy related to abortion, framing the issue as a controversial political and moral topic. The second emphasised uncommon and problematic aspects of abortion, neglecting to present it as a commonplace and safe reproductive healthcare procedure. Two other frames seek to undermine women's decision-making agency: the marginalisation of women's personal perspectives; and the highlighting of prerequisites for abortion care. The media's emphasis on a hierarchy of deservedness may consequently reduce public support for particular reasons for choosing abortion. Overall, our findings show that abortion remains a regularly covered and contentious issue, even amidst progressive legislation. This study highlights the need for balanced reporting that engages with women's diverse personal experiences and perspectives.

本研究利用基于转换器主题建模的自动内容分析法(BERTopic),对荷兰七家主要日报二十年来(2000-2022 年)的堕胎报道在数量和主题方面的跨媒体变化进行了研究。我们的研究结果揭示了对堕胎的持续报道。宗教报纸的报道量明显最高,这表明这些报纸在荷兰的堕胎辩论中占据重要地位。我们在堕胎新闻报道中发现了四种不同的框架。第一种强调政治发展以及与堕胎有关的抗议和宣传,将堕胎问题定位为一个有争议的政治和道德话题。第二种框架强调堕胎中不常见和有问题的方面,而忽视了将其作为一种普通和安全的生殖保健程序。还有两种框架试图削弱妇女的决策权:将妇女的个人观点边缘化;强调堕胎护理的先决条件。媒体对 "应得 "等级的强调可能会因此减少公众对选择堕胎的特定原因的支持。总之,我们的研究结果表明,即使在立法不断进步的情况下,堕胎仍然是一个经常被报道且有争议的问题。本研究强调了平衡报道的必要性,这种报道应涉及妇女不同的个人经历和观点。
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引用次数: 0
Views and experiences of young women from a migrant or refugee background regarding the contraceptive implant in Australia. 有移民或难民背景的年轻女性对澳大利亚避孕植入物的看法和经历。
IF 1.8 3区 医学 Q2 FAMILY STUDIES Pub Date : 2024-11-01 Epub Date: 2024-03-18 DOI: 10.1080/13691058.2024.2328223
Gianna M L Robbers, Natalie Cousins, Yen Li Lim, Jane Estoesta, Jessica R Botfield

Young people comprise a significant proportion of migrants and refugees in Australia. Many encounter challenges in accessing contraception information and services. This study explored the views and experiences of young women from migrant and/or refugee backgrounds regarding the contraceptive implant and related decision-making. Interviews were conducted with 33 women, aged 15-24, living in New South Wales, Australia, who spoke a language other than English and had some experience of the implant. Three themes were developed from the data as follows: 'Finding your own path': contraception decision-making (in which participants described sex and contraception as being taboo in their community, yet still made independent contraceptive choices); Accessing 'trustworthy' contraception information and navigating services (in which participants consulted online resources and social media for contraception information, and preferred discussions with healthcare providers from outside their community); and Views and experiences of the contraceptive implant (while the implant was described as a 'Western' method, most participants regarded it as an acceptable, convenient, cost-effective, and confidential means of contraception). Decision-making regarding the implant is influenced by many factors which must be considered in health promotion efforts and when providing clinical care. Consideration of more informative health promotion resources, peer education strategies, and healthcare provider training is warranted to support contraception decision-making and choice.

在澳大利亚的移民和难民中,年轻人占很大比例。许多人在获取避孕信息和服务方面遇到困难。本研究探讨了具有移民和/或难民背景的年轻女性对避孕植入物及相关决策的看法和经验。研究人员对居住在澳大利亚新南威尔士州的 33 名 15-24 岁女性进行了访谈,这些女性会讲英语以外的语言,并对植入避孕药具有一定的经验。从数据中总结出以下三个主题:寻找自己的道路":避孕决策(参与者认为性和避孕在她们的社区是禁忌,但她们仍然做出了独立的避孕选择);获取 "值得信赖的 "避孕信息和服务导航(参与者通过网络资源和社交媒体获取避孕信息,并倾向于与社区外的医疗服务提供者进行讨论);以及对皮下埋植避孕药的看法和经验(虽然皮下埋植避孕药被描述为一种 "西方 "方法,但大多数参与者认为它是一种可接受的、方便的、经济的和保密的避孕方法)。关于皮下埋植避孕药具的决策受到许多因素的影响,在开展健康促进工作和提供临床护理时必须考虑到这些因素。应考虑提供更多的健康促进资源、同伴教育策略和医疗保健提供者培训,以支持避孕决策和选择。
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引用次数: 0
(In)visibilising pregnancy loss in Southern Malawi. (使马拉维南部的妊娠损失(不)透明化。
IF 1.8 3区 医学 Q2 FAMILY STUDIES Pub Date : 2024-11-01 Epub Date: 2024-03-12 DOI: 10.1080/13691058.2024.2324001
Bregje de Kok, Marion Chirwa Kajombo, Priscilla Matinga, Blessings Kaunda

Miscarriages, stillbirths and neonatal deaths have received limited attention in global health programmes and research, even though pregnancy loss is common, traumatic and stigmatised. This paper seeks to illuminate lived experiences of pregnancy loss in southern Malawi, drawing on findings from semi-structured interviews and focus groups with women who have experienced loss, health professionals and community members, and observations of maternity care. Combining thematic and discourse analysis, we show how societal and medical discourses frame women as responsible for (failed) reproduction, and restrict possibilities to speak about, and respond to, loss. Some accounts and (care) practices invisibilise loss and associated suffering. However, invisibilisation may also be intended as support, and underscores rather than denies the social significance of parenthood. Other accounts (e.g. women emphasising faith and acceptance) constitute moral survival strategies to avoid the acquisition of a 'spoiled identity'. We conclude that societal and medical discourses of loss enact stigmatised, subaltern subject positions for women experiencing pregnancy loss, create social suffering, and amount to a form of structural violence. Programmes and interventions should change these discourses.

流产、死胎和新生儿死亡在全球健康计划和研究中受到的关注有限,尽管妊娠损失是常见的、创伤性的和耻辱性的。本文通过对经历过妊娠损失的妇女、医疗专业人员和社区成员进行半结构式访谈和焦点小组讨论,并对产科护理进行观察,试图阐明马拉维南部妊娠损失的生活经验。结合主题分析和话语分析,我们展示了社会和医疗话语是如何将妇女定格为(失败的)生育责任人,并限制了她们谈论和应对失子的可能性。一些说法和(护理)实践将损失和相关痛苦隐蔽化。然而,这种淡化也可能是一种支持,强调而不是否认为人父母的社会意义。其他一些说法(如妇女强调信仰和接受)则构成了避免获得 "被宠坏的身份 "的道德生存策略。我们得出的结论是,社会和医学的失落论述为经历妊娠失落的妇女确立了污名化的、次等的主体地位,造成了社会痛苦,相当于一种结构性暴力。计划和干预措施应改变这些话语。
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引用次数: 0
Stigmatised as 'promoting' with a duty to report: public healthcare workers providing services to criminalised 'key populations for HIV' under Uganda's 2023 Anti-Homosexuality Act. 被污名化为有义务报告的 "宣传":根据乌干达 2023 年的《反同性恋法》,公共医疗工作者为被定罪的 "艾滋病关键人群 "提供服务。
IF 1.8 3区 医学 Q2 FAMILY STUDIES Pub Date : 2024-10-26 DOI: 10.1080/13691058.2024.2416534
Austin Bryan

This paper analyses the experiences of public healthcare workers in Uganda under the Anti Homosexuality Act (AHA) 2023, who specialise in the provision of HIV prevention and treatment services to criminalised 'key populations' for HIV, including men who have sex with men, transgender women, and female sex workers. Utilising in-depth semi-structured interviews with 17 public healthcare workers and participant observation with LGBTQ+ and HIV activists, public health officials, and development workers, this ethnographic study explored the legal, social and ethical challenges that public healthcare providers faced. Public healthcare workers have experienced various types of stigma from their work, including socio-legal stigma from the criminalisation of 'promoting homosexuality', stigma by association with key populations, concealment stigma, and denial. Legal ambiguities stemming from the AHA 2023 have led to security incidents for some public healthcare workers. The study highlights the ethical dilemmas that have arisen from the 'duty to report' clause, which conflicts with professional healthcare ethics of confidentiality, and the role the Ministry of Health played in passing the AHA 2023, instilling confusion about its enforcement, and minimising and denying the risks the legislation has had on Uganda's HIV epidemic.

本文分析了乌干达公共医疗工作者在《2023 年反同性恋法》(AHA)下的工作经历,他们专门为被定罪的艾滋病 "关键人群"(包括男男性行为者、变性女性和女性性工作者)提供艾滋病预防和治疗服务。这项人种学研究通过对 17 名公共医疗工作者进行深入的半结构式访谈,以及对 LGBTQ+ 和 HIV 活动家、公共卫生官员和发展工作者进行参与式观察,探讨了公共医疗服务提供者所面临的法律、社会和伦理挑战。公共医疗工作者在工作中经历了各种类型的污名化,包括因 "宣扬同性恋 "而被定罪所带来的社会法律污名化、与重点人群的关联所带来的污名化、隐瞒污名化以及否认污名化。AHA 2023》产生的法律模糊性导致一些公共医疗工作者遭遇安全事件。该研究强调了 "报告义务 "条款所带来的道德困境,该条款与医疗保健专业保密道德相冲突,并强调了卫生部在通过《2023 年艾滋病法案》、对其执行造成混淆以及尽量减少和否认该立法对乌干达艾滋病疫情造成的风险方面所扮演的角色。
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