Emlet Charles A
Social Work Program, University of Washington, Tacoma, 1900 Commerce Street, Campus Box 358425, Tacoma, Washington 98402, USA.
AIDS Patient Care STDS. 2006 May;20(5):350-8. doi: 10.1089/apc.2006.20.350.
The purpose of this study was to examine the relationships between age, HIV-related stigma, and patterns of disclosure. Previous literature has suggested that older age is associated with increased HIV stigma and less disclosure of HIV status. Eighty-eight individuals, 44 between the ages of 20-39 and 44 aged 50 and over were recruited for the study through an AIDS service organization in the Pacific Northwest. Subjects in each group were matched as closely as possible by gender, ethnicity, HIV exposure and diagnosis. In a comparison of sociodemographic characteristics, older adults (50+) were significantly more likely to live alone, and to be retired. Younger adults were significantly more likely to be never married/ partnered, unemployed and be recipients of Medicaid. Bivariate analysis revealed no significant differences in overall stigma scores between groups; however, younger adults were more likely to fear losing their job because of HIV. Older adults were less likely to disclose HIV to relatives, partners, mental health workers, neighbors, and church members than those 20-39 years of age. Pearson product moment correlations found disclosure to be significantly associated with time since diagnosis, heterosexual exposure, ethnicity, use of HIV services, and having a confidant. Stigma was associated with ethnicity, having a confidant, and instrumental social support. In a multiple regressions analysis, 48.4% of the variance in disclosure accounted for by time since first diagnosis, service use, and having a confidant. Service use was the only independent variable significantly associated with stigma, accounting for 21.6% of the variance.
本研究的目的是检验年龄、与艾滋病相关的耻辱感以及信息披露模式之间的关系。以往文献表明,年龄较大与艾滋病耻辱感增加及艾滋病状况披露较少有关。通过太平洋西北部的一个艾滋病服务组织招募了88名个体,其中44名年龄在20至39岁之间,44名年龄在50岁及以上。每组中的受试者在性别、种族、艾滋病暴露情况和诊断方面尽可能进行匹配。在社会人口学特征比较中,年龄较大的成年人(50岁及以上)独居和退休的可能性显著更高。年龄较小的成年人从未结婚/有伴侣、失业且接受医疗补助的可能性显著更高。双变量分析显示两组之间总体耻辱感得分无显著差异;然而,年龄较小的成年人更有可能因感染艾滋病而担心失去工作。与20至39岁的人相比,年龄较大的成年人向亲属、伴侣、心理健康工作者、邻居和教会成员披露感染艾滋病情况的可能性较小。皮尔逊积差相关分析发现,信息披露与确诊后的时间、异性接触、种族、使用艾滋病服务以及有知己显著相关。耻辱感与种族、有知己以及工具性社会支持相关。在多元回归分析中,首次确诊后的时间、服务使用情况和有知己解释了信息披露中48.4%的方差。服务使用情况是与耻辱感显著相关的唯一自变量,解释了21.6%的方差。