广西抗病毒治疗HIV感染者/AIDS患者污名特征变化研究  

Changes in stigma characteristics of HIV infection/AIDS patients treated with antiviral therapy in Guangxi

作　　者：黄金萍[1] 黎彦君[1] 李祥青[1] 卢晓燕 刘帅凤[2] 乔杉 董文逸[1] 沈智勇[2] HUANG Jinping;LI Yanjun;LI Xiangqing;LU Xiaoyan;LIU Shuaifeng;QIAO Shan;DONG Wenyi;SHEN Zhiyong(Nanning Fourth People's Hospital,AIDS Clinical Treatment Center of Guangxi(Nanning),Nanning,Guangxi 530023,China;Guangxi Autonomous Regional Center for Disease Prevention and Control,Nanning,Guangxi 530028,China;University of South Carolina,Columbia,America)

机构地区：[1]南宁市第四人民医院,广西艾滋病临床治疗中心,广西南宁530023 [2]广西壮族自治区疾病预防控制中心,广西南宁530028 [3]南卡罗莱纳大学,美国哥伦比亚市

出　　处：《中国热带医学》2023年第9期911-915,940,共6页China Tropical Medicine

基　　金：国家自然科学基金项目(No.81761128004);广西卫健委自筹经费课题(No.Z2014474)。

摘　　要：目的 探讨HIV/AIDS患者污名动态特征,为心理关怀提供科学依据。方法 随机选取南宁市第四人民医院抗逆转录病毒疗法(antiretroviral therapy,ART)治疗的HIV/AIDS患者为研究对象,采用内化艾滋病污名、预期艾滋病污名和遭受艾滋病污名等进行基线及随访1年后问卷调查,比较不同时点的差异,分析HIV/AIDS患者污名变化特征。结果 ART治疗HIV/AIDS患者随访1年,在内化污名8个条目中,感染艾滋病让我觉得很羞耻;感染艾滋病让我觉得自己不干净;我因有艾滋病而觉得自己不如他人;我因有艾滋病而有罪恶感;别人对艾滋病的态度,让我对自己的感受更差了等5个条目的比例从基线的34.0%~43.5%下降到19.5%~29.5%,出现明显改善,差异有统计学意义(χ^(2)=18.586,14.277,10.473,12.219,9.934,P<0.05)。预期艾滋病污名的9个条目中,社区/社区工作人员将不会认真考虑我的需要;社区/社区工作人员将会歧视我;社区/社区工作人员将会拒绝对我提供服务;医护人员将会避免接触我等4个条目的比例从基线16.0%~27.5%下降到7.0%~15.5%,出现明显改善,差异有统计学意义(χ^(2)=13.690,15.787,12.034,12.593,P<0.05)。遭受艾滋病污名的16个条目中,遭受来自丈夫/妻子或者伴侣的心理压力;因为感染艾滋病而被拒绝发生性关系;因为感染艾滋病而丢掉一份工作或者其他经济来源;因为感染艾滋病而被用人单位拒绝或失去一个工作机;因为感染艾滋病而改变工作性质,或者被拒绝升职或提拔;因为感染艾滋病而被拒绝提供医疗服务等6个条目的比例从基线2.5%~15.0%下降到1.0%~8.0%,发生明显改善,差异有统计学意义(χ^(2)=8.619,15.558,6.061,9.049,5.432,8.156,P<0.05)。HIV/AIDS患者遭受到身体上的攻击增加5.5%,差异有统计学意义(χ^(2)=5.368,P<0.05)。结论 HIV/AIDS患者三个维度上的污名有48.48%出现缓解,治疗干预、自我接纳,营造良好的无歧视社会环境对HIV/AIDS患者�Objective To explore the dynamic characteristics of stigmatization in HIV/AIDS patients and provide scientific evidence for psychological care.Methods HIV/AIDS patients receiving antiretroviral therapy(ART)treatment in Nanning Fourth People′s Hospital were randomly selected for baseline and 1 year follow-up questionnaire survey including internalized HIV stigma,anticipated HIV stigma,exposure to HIV stigma.The differences between the two groups at different time points were dynamically compared to analyze the changing characteristics of stigma in HIV/AIDS patients.Results After one year of ART treatment,among the eight items of internalizing stigma,five items including the proportion of feeling ashamed of being infected with HIV/AIDS,feeling unclean because of being infected with HIV/AIDS,feeling inferior to others because of having HIV/AIDS,feeling guilty because of having HIV/AIDS,and having a poorer self-perception due to how others view HIV/AIDS decreased significantly from 34.0%to 43.5%at the baseline to 19.5%to 29.5%,showing significant improvement with statistical significance(χ^(2)=18.586,14.277,10.473,12.219,9.934,P<0.05);among the nine items of anticipated stigma,four items including the proportion of community/community workers not taking my needs seriously,discriminating against me,refusing to provide services for me,and healthcare workers avoiding contact with me decreased significantly from 16.0%to 27.5%at the baseline to 7.0%to 15.5%,respectively,showing significant improvement with statistical significance(χ^(2)=13.690,15.787,12.034,12.593,P<0.05);among the 16 items of exposure to HIV stigma,six items including the proportion of experiencing physical attacks,psychological pressure from spouses/partners,being refused sexual relationships,losing jobs or other economic sources,being rejected or losing a job opportunity due to HIV/AIDS,changing job nature due to HIV/AIDS,or being refused medical services decreased significantly from 2.5%to 15.0%at the baseline to 1.0%to 8.0%,respectively,showing s

关 键 词：艾滋病感染者/艾滋病患者 污名 歧视 随访 动态监测 

分 类 号：R512.91[医药卫生—内科学]