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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中与性健康相关的健康寻求策略研究中的部分发现。在加尔各答关于性工作和性传播疾病的背景信息之后,介绍与妇女对(性)健康,寻求治疗和利用服务的理解有关的发现。在容易获得卫生服务的城市环境中,最初寻求治疗的模式已被证明通常(生物医学上)是适当的,但是随后的“不依从”治疗方法引起了人们的关注。鉴于这些发现,对常规的“寻求健康行为”研究方法进行了回顾,并提出了一些有关方法的适当性的问题,这些方法着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以下因素决定:关于疾病的文化“信仰”。研究方向的内在生物医学和文化主义偏见表明,人们忽视了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。为提供有效的性健康服务的运营研究和政策制定提出了建议,并对旨在改善性健康的干预措施和应用研究的范围产生了影响。

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