Andrewin Aisha, Chien Li-Yin
Central Health Region, Ministry of Health, Local Government, Transport and Communication, Belize, Belize.
AIDS Patient Care STDS. 2008 Nov;22(11):897-906. doi: 10.1089/apc.2007.0219.
This study, conducted from August to September 2007, utilized a population-based survey to investigate stigmatizing attitudes and acts of discrimination against HIV/AIDS patients among doctors and nurses working in public hospitals in Belize. A total of 230 subjects (81.0%) completed the survey. The mean age was 36.8 years; 75% were women; 61% were nurses; 74% were Belizean. Stigmatization was greatest for "attitudes of blame/judgment"; disclosing a patient's HIV/AIDS status to colleagues was the most frequent act of discrimination (29%). Formal HIV/AIDS training was significantly associated with less stigmatization for "attitudes towards imposed measures" (p < .01); "attitudes of blame/judgment" (p < 0.05); and testing without consent (p < 0.05). Doctors showed more stigmatization in "attitudes towards imposed measures," conducted HIV tests without consent and disclosed patient status to colleagues more frequently than nurses (p < 0.05) while nurses gave differential care to patients based on HIV status more frequently (p < 0.01) than doctors. Female and religious health care workers (HCWs) were more stigmatizing in their "attitudes of blame/judgment" than male and nonreligious HCWs (p < 0.05). Cuban HCWs were more stigmatizing in their "attitudes toward imposed measures" and were less comfortable dealing with HIV/AIDS patients than their Belizean counterparts (p < 0.01). Older age was associated with less frequent disclosure of patients' HIV status (p < 0.05). HIV/AIDS training that incorporates stigma reduction strategies tailored to the target groups identified is needed. Additionally, we recommend that the effectiveness of national HIV/AIDS policies be investigated.
这项于2007年8月至9月开展的研究，采用了一项基于人群的调查，以调查伯利兹公立医院医护人员中针对艾滋病毒/艾滋病患者的污名化态度和歧视行为。共有230名受试者（81.0%）完成了调查。平均年龄为36.8岁；75%为女性；61%为护士；74%为伯利兹人。“指责/评判态度”的污名化程度最高；向同事透露患者的艾滋病毒/艾滋病状况是最常见的歧视行为（29%）。接受正规的艾滋病毒/艾滋病培训与“对强制措施的态度”（p<0.01）、“指责/评判态度”（p<0.05）以及未经同意进行检测（p<0.05）方面污名化程度较低显著相关。医生在“对强制措施的态度”方面表现出更多污名化，未经同意进行艾滋病毒检测并向同事透露患者状况的频率高于护士（p<0.05），而护士基于艾滋病毒状况对患者区别对待的频率高于医生（p<0.01）。女性和有宗教信仰的医护人员在“指责/评判态度”方面比男性和无宗教信仰的医护人员污名化程度更高（p<0.05）。古巴医护人员在“对强制措施的态度”方面污名化程度更高，且在与艾滋病毒/艾滋病患者打交道时比伯利兹同行更不自在（p<0.01）。年龄较大与较少透露患者艾滋病毒状况相关（p<0.05）。需要开展纳入针对已确定目标群体的减少污名化策略的艾滋病毒/艾滋病培训。此外，我们建议对国家艾滋病毒/艾滋病政策的有效性进行调查。
