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This paper presents and discusses selected findings from a study of health-seeking strategies in relation to sexual health among a group of female sex workers in Calcutta, India. Background information on sex work and sexually transmitted disease in Calcutta is followed by the presentation of findings pertaining to women's understandings of (sexual) health, treatment-seeking and service utilisation. In the urban context where health services are readily available, patterns of initial treatment-seeking are shown to be generally (biomedically) appropriate, but subsequent "non-compliant" therapeutic practices give cause for concern. Conventional approaches to the study of "health-seeking behaviour" are reviewed in the light of these findings and questions raised about the appropriateness of approaches that focus on initial choice of treatment type and/or assume processes of health-seeking to be determined primarily by cultural "beliefs" about illness. Inherent biomedical and culturalist biases in the orientation of such research are shown to produce an analytic neglect of the dual influences of material life conditions and people's perceptions of health, rather than illness, upon health-related strategies. Recommendations are made for operational research and policy formulation on the provision of effective sexual health services, and implications are drawn for the scope of interventions and applied research directed at improving sexual health.

译文

本文介绍并讨论了印度加尔各答一群女性性工作者与性健康有关的寻求健康策略研究的部分发现。关于加尔各答性工作和性传播疾病的背景信息之后,介绍了与妇女对 (性) 健康,寻求治疗和服务利用的理解有关的发现。在容易获得医疗服务的城市环境中,最初寻求治疗的方式通常 (在生物医学上) 是适当的,但是随后的 “不合规” 治疗方法引起了人们的关注。根据这些发现和提出的有关方法的适当性的问题,对 “寻求健康行为” 研究的常规方法进行了审查,这些方法侧重于治疗类型的初始选择和/或假设寻求健康的过程主要由关于疾病的文化 “信仰” 决定。这种研究方向上固有的生物医学和文化主义偏见被证明是对物质生活条件和人们对健康而不是疾病的看法对健康相关策略的双重影响的分析忽略。提出了有关提供有效性健康服务的业务研究和政策制定的建议,并对旨在改善性健康的干预措施和应用研究的范围提出了影响。

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