性社会学研究 | Culture, Health & Sexuality 英文文献编译（二）

【编者按】

　　性社会学，只不过是社会学的一个弱小分支。在西方，它发展不过百年，学者不过百人；在中国则更是历史短而人数少，但是，它研究的却是人类生活中发生最频繁、体验最深刻、意义最广泛的重大活动之一。人类智慧数千年来对于自身的几乎一切认识和争论，都可以在“性”（sexuality）这里得到集中的体现：精神与肉体、个人与社会、美与丑、生命与死亡，等等，不一而足。不妨说，“性”是研究人类的最佳切入点之一。

　　在2019年，性研究ing将在介绍会议论文及其他重要原创性研究成果之余，推出“性社会学研究文献回顾”栏目，介绍发表在中英文期刊上的部分性研究文献（仅摘编题目与摘要），为学术研究提供一些检索便利，也方便了解中文的研究语境。中文文献的梳理偏重中国大陆，以五年为间隔，以社会学与人类学领域为主。英文文献以 Culture, Health and Sexuality 为主，介绍最新期刊的论文情况。

　　本期编译的是《文化、健康与性》（Culture, Health and Sexuality）杂志的第21卷2019年第4期，共8篇论文。具体发表信息可见文章末尾“阅读原文”链接。

01

与HIV相关的“阴谋信条”：纽约市HIV携带者

遭受种族主义和社会经济排挤的生活经历

Jessica Jaiswal, Stuart N. Singer,

Karolynn Siegel et al.

　　与HIV（人类免疫缺陷病毒）相关的“阴谋信条”包含了对HIV的屠杀式起源以及对HIV相关药物的性质和目的看法。这些看法对包括生育控制和HIV检测在内的无数健康行为和结果的影响已被广泛记录。大多数与HIV相关的研究已用定量方法对这一现象进行了探究；然而为了更好地理解这些信条的支持者们所阐述的观点的复杂性，进一步的定性研究是必要的。此外，公共卫生总体上过分强调了塔斯基吉梅毒研究在解释疑虑方面的作用，而没有关注持续的社会不平等。本研究对当前或不久前脱离HIV医疗照护的低收入黑人和拉丁裔HIV携带者进行了27次半结构式访谈。对政府和制药业在这一流行病中的角色和意义的看法突出表现了受访者所经历的种族主义和阶级主义偏见。然而值得注意的是，提供HIV照护的人并没有被视为政府与制药商勾结的一部分。干预措施应侧重于培养对HIV药物治疗的积极看法，并在提供HIV照护的人和遭受持续的社会经济排斥的人群之间建立信任。用更具描述性的词语来代替“阴谋信条”，比如“与HIV相关的信念”，可以避免对人们生活体验的怀疑。

HIV-related ‘conspiracy beliefs’: lived experiences of racism and socio-economic exclusion among people living with HIV in New York City

HIV-related ‘conspiracy beliefs’ include ideas about the genocidal origin of HIV and the nature and purpose of HIV-related medications. These ideas have been widely documented as affecting myriad health behaviours and outcomes, including birth control use and HIV testing. Most HIV-related research has quantitatively explored this phenomenon, and further qualitative research is necessary to better understand the complexity of these beliefs as articulated by those who endorse them. Moreover, public health in general has over-emphasised the role of the Tuskegee Syphilis Study in explaining mistrust, rather than focus on ongoing social inequalities. Twenty-seven semi-structured interviews were conducted with low-income Black and Latinx people living with HIV who were currently, or had been recently, disengaged from HIV medical care. Beliefs about the role and intentions of the government and pharmaceutical industry in the epidemic highlighted the racism and classism experienced by participants. Notably, however, HIV care providers were not perceived as part of the government–pharmaceutical collusion. Interventions should focus on fostering positive beliefs about HIV medication and building trust between HIV care providers and populations that have experienced ongoing social and economic exclusion. Replacing the phrase ‘conspiracy beliefs’ with more descriptive terms, such as HIV-related beliefs, could avoid discrediting people’s lived experiences.

02

处理社会性别：

乌干达北部年轻人于生命历程中

再生产和改变性别规范的生活体验

Rebecka Lundgren, Sarah Burgess,

Heather Chantelois et al.

　　10-19岁是人类发展的一个关键阶段；在此期间，男孩和女孩学习并表现社会构建的性别规范，这将对他们的性和生殖健康产生长远影响。本同期群民族志研究试图理解在冲突后的乌干达北部，社会性别规范和实践在从儿童向青年转变的过程中是如何发展的。我们使用目的抽样法，共选取了60名年龄在10-19岁的女孩和男孩，于三年内进行深度访谈；47人完成了所有的四次访谈。借鉴女权主义理论和生态学视角，本文利用研究结果建构起一个概念框架，展示了年轻人对待男权的和其他性别规范的经历，强调他们在六个关键领域中（工作、青春期、计划生育、亲密伴侣关系、儿童管教、饮酒）践行和协商性别规范的生活过程。该框架指出，以下因素可能鼓励年轻人随着年龄的增长而走向某种规范：（1）个人因素（知识、能动性和志向）；（2）社会因素（社会化过程、资本、成本和后果）；以及（3）结构性因素（卫生/教育系统、宗教机构、政府政策）。这些发现可以为政策和项目提供信息，以改变性别规范以及推动发展平等、健康的关系。

Processing gender: lived experiences of reproducing and transforming gender norms over the life course of young people in Northern Uganda

The years between 10–19 represent a critical stage of human development during which boys and girls learn and embody socially constructed gender norms, with long-term implications for their sexual and reproductive health. This ethnographic cohort study sought to understand how gendered norms and practices develop during the transition from child to young adult in post-conflict northern Uganda. A total of 60 girls and boys aged 10–19 were selected using purposive sampling for in-depth interviews over a three-year period; 47 individuals completed all four interviews. Drawing on feminist theory and an ecological perspective, findings were used to create a conceptual framework displaying the experiences of young people navigating patriarchal and alternative norms, emphasising their lived processes of performing and negotiating norms within six key domains (work, puberty, family planning, intimate partner relations, child discipline and alcohol). The framework identifies: (1) personal factors (knowledge, agency and aspirations); (2) social factors (socialisation processes, capital, costs and consequences); and (3) structural factors (health/educational systems, religious institutions, government policies) which may encourage young people towards one norm or another as they age. These findings can inform policies and programmes to transform gender norms and promote equitable, healthy relationships.

03

BDSM，行为的“生成”和欲望的流动

Charlotta Carlström

　　基于在瑞典对BDSM（绑缚与调教，支配与臣服，施虐与受虐）进行的五年定性民族志研究，本文考察了成为BDSM践行者的过程。笔者对29名自我界定为BDSM践行者的受访者进行了深度访谈，并对他们的叙述进行了主题分析。聚焦于德勒兹“生成”（becoming）的概念，BDSM被理解为一个与幻想、记忆和渴望紧密相连的、动态的和集体的现象，并通过欲望的流动得以实现。实践BDSM可以被理解为一个不断扩大、创造和联系的过程，在这个过程中，欲望不是我们缺乏或需要的东西，而是一个努力和自我提升的过程。更充分地探索“生成”的过程能够帮助我们更好地理解为什么有些人选择实践BDSM。

BDSM, becoming and the flows of desire

Based on a five-year qualitative ethnographic study of Bondage and Discipline/Dominance and Submission/Sadism and Masochism (BDSM) in Sweden, this paper examines the process of becoming among BDSM practitioners. In-depth interviews were completed with 29 self-defined BDSM practitioners, and their accounts were analysed using thematic analysis. Focusing on the Deleuzian concept of becoming, BDSM is understood as a dynamic and collective phenomenon closely connected to fantasies, memories and longing, and enabled through flows of desire. Practising BDSM can be understood as a process of increasing expansion, creation and connection, in which desire is seen not as something we lack or need but rather as a process of striving and self-enhancement. Exploring the becoming process more fully can provide a better understanding as to why some people choose to practise BDSM.

04

印度男男性行为者中的综合症及HIV相关的性风险：

污名及恢复力的影响

Venkatesan Chakrapani, Manmeet Kaur,

Peter A. Newman et al.

　　以综合症理论（syndemics theory）为框架，我们探究了印度男男性行为者的经历；这些经历与四种综合症状（抑郁、酗酒、内化同性恋污名、暴力受害）以及理解他们的恢复力来源有关。我们在目的抽样选中的不同男性中开展了五个焦点组访谈，并对HIV服务提供者进行了七次关键人访谈。受访者的叙述表明，通过各种途径，这些综合症状之间相互作用，依次或同时增加了HIV感染风险。来自一系列加害者（家庭、恶棍和警察）的歧视和暴力助长了同性恋污名的内化和/或抑郁，又转而导致一些男子使用酒精作为应对策略。与同性间的性、社会性别不一致和性工作相关的污名导致了一种或多种综合症状的产生。虽然家庭和固定男性伴侣的拒绝会导致抑郁/酗酒，但家庭、固定伴侣和同伴的支持也是恢复力的来源。在印度，可以通过多层次、多部门的干预措施来减少交叉污名、解决综合症状况并增强恢复力——特别要促进家庭的接受和同伴的支持，以加强对男男性行为者的HIV预防和健康促进工作。

Syndemics and HIV-related sexual risk among men who have sex with men in India: influences of stigma and resilience

Using syndemics theory as a framework, we explored the experience of men who have sex with men in India in relation to four syndemic conditions (depression, alcohol use, internalised homonegativity and violence victimisation) and to understand their resilience resources. Five focus groups were conducted among a purposive sample of diverse men along with seven key informant interviews with HIV service providers. Participants’ narratives suggested various pathways by which syndemic conditions interact with one another to sequentially or concurrently increase HIV risk. Experiences of discrimination and violence from a range of perpetrators (family, ruffians and police) contributed to internalised homonegativity and/or depression, which in turn led some men to use alcohol as a coping strategy. Stigma related to same-sex sexuality, gender non-conformity and sex work contributed to the production of one or more syndemic conditions. While rejection by family and male regular partners contributed to depression/alcohol use, support from family, regular partners and peers served as resources of resilience. In India, HIV prevention and health promotion efforts among men who have sex with men could be strengthened by multi-level multi-component interventions to reduce intersectional/intersecting stigma, address syndemic conditions and foster resilience – especially by promoting family acceptance and peer support.

05

加拿大女性HIV携带者关于母亲身份的决策：

多维风险的磋商

Isabelle Toupin, Kim Engler,

Bertrand Lebouché et al.

　　在加拿大，很少有人研究女性HIV携带者对母亲身份各阶段决策的看法。2004-2005年，我们对在蒙特利尔招募的42名来自非洲、高加索和海地的HIV阳性妇女进行了半结构式访谈。她们所有人都已经是或希望成为亲自孕产的母亲。受访者们描述了三种文化上人们熟知的母亲身份模式，这些模式影响决策和风险感知；我们将其用于组织对访谈材料的主题分析。对于那些认为做母亲是“自我实现和完善”的女性而言，HIV的母婴传播是一个首要问题；这威胁到她们作为“好母亲”的身份，也意味着她们会坚持抗逆转录病毒疗法。对于那些把做母亲视为“社会实现”（全是非洲人或海地人）的女性而言，对生育名声受损的恐惧占据了主导地位；不怀孕威胁到了她们的社会地位并会被社区里的人认为是不健康的；分娩后，她们担心抗逆转录病毒药物会暴露自己的HIV携带者身份而不愿坚持用药。对于支持母亲身份的“个人成长”模式的女性（全是高加索人）而言，对个人健康的威胁是最首要的；怀孕意味着净化身体和灵魂；被视为污染物的抗逆转录病毒药物在分娩后停止使用。这些发现可以为当前的相关研究提供有用信息；并提高健康服务提供者的敏感性，使其关注HIV阳性妇女在与母亲身份有关的决策中所面临的复杂的生理、心理、社会和精神风险，从而实现更加以病人为中心的照护工作。

Decision-making about motherhood among women living with HIV in Canada: a negotiation of multidimensional risks

Little research in Canada has examined the perspectives of women living with HIV on decision-making across the stages of motherhood. In 2004–2005, semi-structured interviews were conducted with 42 African, Caucasian and Haitian HIV-positive women recruited in Montreal. All were or wished to be biological mothers. Transcripts underwent thematic analysis organised by three culturally informed models of motherhood described by the participants, which influenced decision-making and perceived risks. For women who saw motherhood as ‘self-fulfilment and completeness’, vertical HIV transmission was a primary concern. It threatened their identity as a ‘good mother’, which also meant adhering to antiretrovirals. For women who viewed motherhood as a ‘social realisation’ (all African or Haitian), fears of compromised fertility dominated. Not becoming pregnant threatened their social status and presumed health within their community. Antiretrovirals were abandoned after delivery, fearing they would reveal their HIV status. For women endorsing a ‘personal growth’ model of motherhood (all Caucasian), threats to personal health were paramount. Pregnancy meant purifying body and soul. Antiretrovirals, seen as pollutants, were stopped after delivery. These findings can inform current research and sensitise health providers to the complex biological, psychological, social and spiritual risks that HIV-positive women negotiate in motherhood-related decision-making, towards more patient-centred care.

06

埃塞俄比亚携带HIV的女性同伴教育者

生命历程中的性别、权力和亲密关系

Sophia Ahmed Hussen, Meron Gurji Argaw,

Mulugeta Tsegaye et al.

　　从历史上看，埃塞俄比亚妇女在个人、关系和社区层面面临着诸多对性别平等的挑战；这些不平等会导致感染HIV的风险增加。过去二十年里，在以减少性别不平等为目的的政策与规范改变方面取得了一些进展。我们试图理解一群携带HIV的埃塞俄比亚妇女的婚姻和其他浪漫/性关系在生命历程中是如何受到性别规范、关系权力动态和HIV状况的影响的。我们对19名携带HIV的妇女进行了深度访谈，她们在埃塞俄比亚阿地斯亚贝巴的一家大型诊所担任同伴教员。回顾早年的生活，受访者经常描述她们以前经历的以强奸、强迫婚姻和隐瞒HIV状况为特征的创伤性亲密关系。在被诊断感染HIV后，受访者们最近的亲密关系体现了一种更加平等的动态，其特征是相互支持参与艾滋关怀和开放的交流。受访者的叙述展现了鼓舞人心的例子，说明了HIV阳性的妇女即使在多重障碍的情况下，也能够形成和维持平等而令人满意的个人关系。

Gender, power and intimate relationships over the life course among Ethiopian female peer educators living with HIV

Historically, Ethiopian women have faced numerous challenges to gender equity at the individual, relational and community levels; such inequalities can lead to increased risk of HIV acquisition. Over the past two decades, some progress has been made towards changing policies and norms to reduce gender inequality. We sought to understand the ways in which marriage and other romantic/sexual relationships of a group of Ethiopian women living with HIV had been impacted by gender norms, relational power dynamics and HIV status over the life course. We conducted in-depth interviews with 19 women living with HIV who were working as peer educators at a large clinic in Addis Ababa, Ethiopia. Reflecting on their early lives, participants often described traumatic prior relationships characterised by rape, forced marriage and HIV nondisclosure. In the aftermath of being diagnosed with HIV, participants’ more recent relationships embodied a more egalitarian dynamic characterised by mutual support for HIV care engagement and open communication. Participants’ narratives illustrate encouraging examples of ways in which HIV-positive women can form and maintain equitable and satisfying personal relationships even in the context of obstacles at multiple levels.

07

约旦年轻女性青少年时期结婚和做母亲的经历

Manal Ibrahim Al-Kloub, Hanan J. Al-Zein,

Maysoon S. Abdalrahim et al.

　　青少年怀孕和早为人母的现象与糟糕的社会和身体结果有关。本研究考察了约旦年轻女性结婚和做母亲的经历。研究采用描述性定性研究设计，通过滚雪球抽样法选取了住在约旦首都安曼东部的、青少年时期结过婚和当过母亲的受访者（n=15，15-37岁）。资料由面对面录音访谈收集，并按主题进行分析。确立的五个主题为：个人发展的机会丧失、学会惟命是从和优柔寡断、对文化规范的不确定、对母亲角色的矛盾感受，以及增强自己面对生活需求的能力。研究结果表明，约旦青少年女孩结婚和做母亲的经历大多是负面的；她们感到自己被剥夺了权利、尊重和作为一个年轻人的体验。此外，她们感到向母亲身份的转变非常困难，她们被迫过早地承担成年人的社会角色和责任，这使她们经历了太多挑战。青少年母亲是一个弱势群体，她们应该更好地被预防和干预项目所关注。

Young women’s experience of adolescent marriage and motherhood in Jordan

Adolescent pregnancy and early motherhood are associated with poor social and physical outcomes. This study explored the experiences of marriage and motherhood among Jordanian young women. A descriptive qualitative design was employed. Participants (n = 15, age 15–37 years) who had experienced adolescent marriage and motherhood and who lived in eastern Amman, the capital of Jordan, were selected via snowball sampling. Data were collected by tape-recorded face-to-face interviews and analysed thematically. Five themes were identified: lost opportunities for personal development, learning to be submissive and indecisive, uncertainty toward cultural norms, ambivalent feelings toward a maternal role and empowering oneself to face life demands. The findings indicate that the experience of marriage and motherhood among Jordanian adolescents was mostly negative; they felt that they had been deprived of their rights, respect and the experience of being a young person. Additionally, they felt that the transition into motherhood was very difficult, and that they were prematurely forced into adult social roles and responsibilities, which caused them to experience numerous challenges. Adolescent mothers are a vulnerable group that should be better targeted by prevention and intervention measures.

08

“像我们这样的人”：街头女性性工作者

关于健康、污名、权力和主体性的空间化观念

Treena Orchard, Angela Murie,

Holli-Lynn Elash et al.

　　大多数关于街头女性性工作者的健康、安全和服务提供的空间视角研究都发生在大城市，这些研究记录了对地理空间的社会法律层面及道德层面的监测如何限制了她们的日常活动并损害她们照顾自己的能力。为了提供在较小的城市里关于性工作更广泛的社会文化和环境景观的新知识，我们对在加拿大一个中等城市工作的33名女性进行了定性访谈和社会制图。研究发现，关于服务提供、暴力和污名的社会空间是相交的，在性交易空间同时也往往是贫困人口聚居地的情况下，这很常见。本研究中的女性采用独特的能动策略来驾驭这些相互竞逐的力量，其中许多策略利用不同城市空间的多种用途来优化服务获取渠道、降低暴力倾向和帮助她们有尊严地管理自己的健康。研究还考察了她们对空间化术语“无处不在”的使用，这是一个有关权力、能动性和她们渴望加入更广泛的公民话语、表达悲苦的习语。这些材料对从事性工作的女性关于健康、污名、能动性和主观性的空间化观念以及她们如何管理“有风险的”环境提供了新的见解。

“People like us”: spatialised notions of health, stigma, power and subjectivity among women in street sex work

Most spatially-oriented studies about health, safety and service provision among women in street sex work have taken place in large urban cities and document how the socio-legal and moral surveillance of geographical spaces constrain their daily movements and compromise their ability to care for themselves. Designed to contribute new knowledge about the broader socio-cultural and environmental landscape of sex work in smaller urban centres, we conducted qualitative interviews and social mapping activities with thirty-three women working in a medium-sized Canadian city. Our findings demonstrate a socio-spatial convergence regarding service provision, violence, and stigma, which is common in sex trading spaces that double as service landscapes for poor populations. Women in this study employ unique agential strategies to navigate these competing forces, many of which draw upon the multivalent uses of different urban spaces to optimise service access, reduce the propensity for violence, and manage their health with dignity. Their use of the spatialised term ‘everywhere’ as an idiom of distress regarding issues of power, agency and their desire to take part in wider civic discourse are also explored. These data contribute new insights about spatialised notions of health, stigma, agency, and subjectivity among women in sex work and how they manage ‘risky’ environments.

往期

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