中国东部三省份农村成年人乙型肝炎歧视现状及其影响因素  

Present situation and influencing factors of discrimination against hepatitis B patients and carriers among rural adults in three eastern provinces in China

作　　者：于丽洁[1] 刘鸿宇[2] 郑娟[1] 刘汝刚[1] Knut R.Wangen 王健[1] 

机构地区：[1]山东大学公共卫生学院社会医学与卫生事业管理研究所,济南250012 [2]宁夏医科大学管理学院 [3]奥斯陆大学卫生管理与卫生经济系

出　　处：《中华预防医学杂志》2015年第9期771-776,共6页Chinese Journal of Preventive Medicine

基　　金：挪威研究委员会资助项目（196400/S50）

摘　　要：目的：分析中国东部3个省份农村地区成年人乙型肝炎歧视的现状及其影响因素。方法于2011—2012年采用概率比例规模（PPS）抽样方法，选取北京市、河北省、山东省的7个县22个村18岁以上居民作为调查对象，共9269名。采用自行设计的结构式调查问卷对其社会人口学特征、对乙型肝炎患者及乙型肝炎病毒（HBV）携带者的态度、乙型肝炎疫苗接种史进行入户调查。分析调查对象乙型肝炎歧视得分及其分布情况，并通过多因素logistic回归模型分析乙型肝炎歧视的影响因素。结果51.15%（4741名）的调查对象在与乙型肝炎患者或病毒携带者接触的过程中感到恐惧、担心自己被传染；分别有51.29%（4754名）、61.14%（5667名）、52.22%（4841名）的调查对象不愿意接受其礼物、与其一起吃饭、与其握手拥抱；有73.92%（6852名）的调查对象不愿意孩子与乙型肝炎患者或病毒携带者的孩子玩耍；86.68%（8034名）的调查对象不愿意孩子与乙型肝炎患者或病毒携带者结婚。所有调查对象中，完全无歧视（乙型肝炎歧视得分为0分）者仅占0.88%（82名），无歧视或轻度歧视者（0〈得分≤5分）占23.70%（2197名），严重歧视者（得分≥6分）占76.30%（7072名）。多因素logistic回归模型分析结果显示，与农民相比，打工者、技术员、公职人员/村医发生严重乙型肝炎歧视的OR（95%CI）值分别为0.86（0.75～0.98）、0.77（0.67～0.87）、0.57（0.41～0.79）；与低收入组（人均〈10000元/年）相比，高收入组（人均〉40000元/年）发生严重乙型肝炎歧视的OR（95%CI）值为0.57（0.46～0.70）；严重歧视发生率仍随受教育程度的提高而下降，相比文盲组，高中以上教育水平组发生严重乙型肝炎歧视的OR（95%CI）值为0.64（0.51～0.80）；与自评健康水平非常好者相比，自评健康水平非常差者发生严重歧视的OR（Objective To analyze the present situation and influencing factors of discrimination against hepatitis B patients and carriers among rural adults in three eastern provinces in China. Methods By using the method of probability proportionate to size （PPS）,we involved a sample of 9 269 rural adults aged above 18 years old from 22 villages of 7 counties in Beijing, Hebei,Shandong in 2011 and 2012. We used a self-designed interview questionnaire with questions about the individual and household characteristics, attitudes toward hepatitis B patients and carriers, individual HBV vaccination history, etc. We analyzed the hepatitis B discrimination score and its distribution, and we also created a multinomial logistic regression model to analyze the influencing factors of discrimination. Results Of all the participants, 51.15%（4 741）were afraid of being infected with HBV when getting on with hepatitis B patients or carriers;51.29%（4 754）, 61.14%（5 667）and 52.22%（4 841）of them were not willing to accept 〈br〉 gifts from hepatitis B patients or carriers, have dinner with them ,or hug and shake hands with them, respectively; 73.92%（6 852）were unwilling to their children＇s playing with kids whose parents were hepatitis B patients or carriers, and 86.68%（8 034）were unwilling to their children＇s marrying hepatitis B patients or carriers. Of all the participants, only 0.88%（82）were totally discrimination-free （discrimination score=0）;mild or without discrimination （〈0 discrimination score≤5） accounted for 23.70%（2 197/9 269）;severe discrimination （discrimination score ≥6） accounted for 76.30%（7 072）. The multiple multinomial logistic regression showed that migratory workers, other occupations like technician, civil servants and village doctors were less likely to show severe HBV-related discrimination compared with farmers, with OR （95%CI） 0.86 （0.75-0.98）, 0.77 （0.67-0.87）, 0.57 （0.41-0.79）, respectively. Compared with the lowest income group （�

关 键 词：成年人 农村人口 肝炎 乙型 横断面研究 偏见 

分 类 号：R512.62[医药卫生—内科学]