"我不想看起来瘦得像病人":南得克萨斯州感染艾滋病毒的西班牙裔人对身体形象和减肥的看法。

Jordan W Abel, Omar Allen, Delia Bullock, Erin Finley, Elizabeth A Walter, Phillip W Schnarrs, Barbara S Taylor
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引用次数: 0

摘要

目的:艾滋病病毒感染者(PLWH)和西班牙裔肥胖症患者人数不断增加。艾滋病和肥胖都与心血管疾病的发病率和死亡率有关。我们的目标是了解西班牙裔艾滋病感染者对身体形象和生活方式的看法,以便适当调整干预措施:我们对 22 名西班牙裔 PLWH 和 6 名医疗服务提供者进行了半结构化访谈。我们对 22 名西班牙裔 PLWH 和 6 名医疗服务提供者进行了半结构式访谈,有目的的抽样选取了不同体重和性别的患者参与者。采用基础理论对访谈进行编码和分析,比较肥胖患者和非肥胖患者、患者和医疗服务提供者的观点:结果:参与者认为肥胖和糖尿病在社区中是 "正常 "的。患者表现出对健康饮食和生活方式的理解,但认为自己没有能力保持健康饮食和生活方式。当地肥胖症的流行归咎于传统的西班牙食物。五名患者将体重等同于健康,将体重减轻等同于疾病,四名患者表示担心体重减轻会导致无意中泄露 HIV 感染状况。超重或肥胖的参与者表示意识到了自己的体重,并觉得受到了医疗服务提供者的羞辱。医疗服务提供者认为减肥干预无效:对这一人群的干预必须解决已发现的障碍:将超重/肥胖作为一种规范价值、缺乏自我效能感、围绕食物的文化信仰、害怕与艾滋病相关的体重减轻和耻辱感,以及提供者对干预无效的看法。
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"I don't want to look sick skinny": Perceptions of Body Image and Weight Loss in Hispanics Living with HIV in South Texas.

Objective: Obesity is rising in people with HIV (PLWH) and Hispanics. Both HIV and obesity are associated with cardiovascular disease morbidity and mortality. Our goal is to understand perceptions of body image and lifestyle in Hispanics with HIV to adapt interventions appropriately.

Methods: We conducted semi-structured interviews with 22 Hispanic PLWH and 6 providers. Purposive sampling selected patient participants across weights and genders. Interviews were coded and analyzed using grounded theory, comparing perspectives between patients with and without obesity, and patients and providers.

Results: Participants felt obesity and diabetes were "normal" in the community. Patients exhibited understanding of healthy diet and lifestyle but felt incapable of maintaining either. Traditionally Hispanic foods were blamed for local obesity prevalence. Five patients equated weight with health and weight loss with illness, and four expressed concerns that weight loss could lead to unintentional disclosure of HIV status. Participants with overweight or obesity expressed awareness of their weight and felt shamed by providers. Providers found weight loss interventions to be ineffective.

Conclusion: Interventions in this population must address identified barriers: overweight/obesity as a normative value, lack of self-efficacy, cultural beliefs surrounding food, fear of HIV-associated weight loss and stigma, and provider perspectives on intervention futility.

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