Abstract：Objective To learn HIV related stigma and its associated factors among the patients on antiretroviral therapy ( ART ) in Wenshan Prefecture, Yunnan Province, so as to provide evidence for eliminating HIV discrimination. Methods A total of 419 subjects were recruited by convenience sampling from three ART clinics in Wenshan City and Maguan County between October 2017 and January 2018. HIV/AIDS Related Stigma and Discrimination Scale developed by Li Xianhong et al was employed. The multivariate linear regression model were used to explore the influencing factors for HIV stigma. Results The median scores of disclosure concern, public rejection, family stigma, internalized stigma, health service providers＇ stigma were 24.00, 6.00, 10.00, 20.00, 2.00, respectively, and the overall was 68.00. The multivariate linear regression analysis showed that female patients ( standardized β=0.135 ) , patients with opportunistic infection ( standardized β=0.120 ), patients had no HIV infected family member ( standardized β=-0.128 ) , patients without family support ( standardized β=-0.175 ) , patients received gift from ART clinics ( standardized β=0.124 ) , patients scored lower in ART knowledge ( standardized β=-0.117 ) were likely to scored higher in HIV stigma. Conclusions The stigma on disclosure concern and internalized stigma dimensions are grievous among ART patients in Wenshan Prefecture. Gender, opportunistic infection, HIV infection in family, family support, receiving incentive gifts from clinics and awareness of ART are associated with HIV stigma.
[1] 王科坤,杨银梅,姚星,等.武汉市HIV/AIDS病人感知歧视现状及相关因素分析[J] .中国艾滋病性病杂志,2018,24(7):667-670. [2] KALICHMAN S,SHKEMBI B,HERNANDEZ D,et al.Income inequality,HIV stigma,and preventing HIV disease progression in rural communities[J] .Prev Sci,20(7):1066-1073. [3] CORDEIRO DUTRA A F,CORDOVA W,AVANT F.Services,stigma,and discrimination:perceptions of African descendant men living with HIV/AIDS in Brazil and in the United States[J] .Soc Work Public Health,2018,33(4):226-236. [4] 胡晓松,陈芳,丁凡,等.中国三城市HIV阳性男男性行为人群接受随访与抗病毒治疗服务状况及其影响因素分析[J] .中华预防医学杂志,2015,49(11):945-949. [5] CHAMBERS L A,RUEDA S,BAKER D N,et al.Stigma,HIV and health:a qualitative synthesis[J] .BMC Public Health,2015,15:848. [6] PANTELIC M,BOYES M,CLUVER L,et al.They say HIV is a punishment from god or from ancestors＇:cross-cultural adaptation and psychometric assessment of an HIV stigma scale for South African adolescents living with HIV(ALHIV-SS)[J] .Child Indic Res,2018,11(1):207-223. [7] HUA J,EMRICK C B,GOLIN C E,et al.HIV and Stigma in Liuzhou,China[J] .AIDS Behav,2014,18(Suppl. 2):S203-S211. [8] 李现红,何国平,王红红,等.HIV/AIDS相关羞辱和歧视量表的编制及评价[J] .中国护理杂志,2010,45(6):496-499. [9] 陈然,王瑜,余建英,等.PHQ-9在综合医院住院患者中信效度研究[J] .四川精神卫生杂志,2017,30(2):149-153. [10] 孙振晓,孙宇新,于相芬,等.广泛性焦虑量表在颈椎病患者焦虑情绪评估的信度和效度研究[J] .临床精神医学杂志,2017,27(4):250-252. [11] 何筱衍,李春波,钱洁,等.广泛性焦虑量表在综合性医院的信度和效度研究[J] .上海精神医学杂志,2010,22(4):200-203. [12] 胡晓松,赵燕,吴尊友.云南省文山州HIV感染者抗病毒治疗脱失影响因素的定性研究[J] .中华疾病控制杂志,2018,22(8):822-825. [13] SIRIL H N,KAAYA S F,SMITH FAWZI M K,et al.Clinical outcomes and loss to follow-up among people living with HIV participating in the NAMWEZA intervention in Dar es Salaam,Tanzania:a prospective cohort study[J] .AIDS Res Ther,2017,14(1):18. [14] 罗珊霞,杨冬菊,黄霞,等.HIV感染者与AIDS患者感知歧视影响因素的横断面调查[J] .中国循证医学杂志,2018,18(6):560-564. [15] LETSHWENYO-MARUATONA S B,MADISA M,BOITSHWARELO T,et al.Association between HIV/AIDS knowledge and stigma towards people living with HIV/AIDS in Botswana[J] .AJAR,2019,18(1):58-64. [16] MANCINELLI S,NIELSEN-SAINES K,GERMANO P,et al.Who will be lost? Identifying patients at risk of loss to follow-up in Malawi.The DREAM Program Experience[J] .HIV Med,2017,18(8):573-579. [17] NYBLADE L,STOCKTON M A,GIGER K,et al.Stigma in health facilities:why it matters and how we can change it[J] .BMC Med,2019,17(1):25. [18] LEE H J,KIM D H,NA Y J,et al.Factors associated with HIV/AIDS-related stigma and discrimination by medical professionals in Korea:a survey of infectious disease specialists in Korea[J] .Niger J Clin Pract,2019,22(5):675-681. [19] AKILIMALI P Z,MUSUMARI P M,KASHALA-ABOTNES E,et al.Disclosure of HIV status and its impact on the loss in the follow-up of HIV-infected patients on potent anti-retroviral therapy programs in a(post-)conflict setting:a retrospective cohort study from Goma,Democratic Republic of Congo[J] .PLoS One,2017,12(2):e0171407. [20] OJWANG＇V O,PENNER J,BLAT C,et al.Loss to follow-up among youth accessing outpatient HIV care and treatment services in Kisumu,Kenya[J] .AIDS Care,2016,28(4):500-507. [21] MBERI M N,KUONZA L R,DUBE N M,et al.Determinants of loss to follow-up in patients on antiretroviral treatment,South Africa,2004-2012:a cohort study[J] .BMC Health Serv Res,2015,15:259. [22] 樊鹏飞,杨晴,毛宇嵘,等.江西省农村地区HIV感染者接受基层医疗卫生机构随访管理现状及相关因素分析[J] .中华流行病学杂志,2019,40(3):346-349.
