Collins Pamela Y, Elkington Katherine S, von Unger Hella, Sweetland Annika, Wright Eric R, Zybert Patricia A
Department of Epidemiology, Columbia University, New York, NY 10032, USA.
Am J Orthopsychiatry. 2008 Oct;78(4):498-506. doi: 10.1037/a0014581.
Urban women with severe mental illness (SMI) are vulnerable to stigma and discrimination related to mental illness and other stigmatized labels. Stigma experiences may increase their risk for negative health outcomes, such as HIV infection. This study tests the relationship between perceived stigma and HIV risk behaviors among women with SMI. The authors interviewed 92 women attending community mental health programs using the Stigma of Psychiatric Illness and Sexuality Among Women Questionnaire. There were significant relationships between personal experiences of mental illness and substance use accompanying sexual intercourse; perceived ethnic stigma and having a riskier partner type; and experiences of discrimination and having a casual or sex-exchange partner. Higher scores on relationship stigma were associated with a greater number of sexual risk behaviors. The findings underscore the importance of exploring how stigma attached to mental illness intersects with other stigmatized labels to produce unique configurations of HIV risk. HIV risk reduction interventions and prevention research should integrate attention to stigmatized identities in the lives of women with SMI.
患有严重精神疾病（SMI）的城市女性容易受到与精神疾病及其他污名化标签相关的耻辱和歧视。耻辱经历可能会增加她们出现负面健康结果的风险，比如感染艾滋病毒。本研究检验了患有严重精神疾病的女性中感知到的耻辱与艾滋病毒风险行为之间的关系。作者使用《女性精神疾病与性取向耻辱问卷》对92名参加社区心理健康项目的女性进行了访谈。精神疾病的个人经历与性交时使用药物之间、感知到的种族耻辱与拥有风险更高的伴侣类型之间、歧视经历与拥有随意性伴侣或性交易伴侣之间均存在显著关系。关系耻辱得分越高，性风险行为的数量就越多。这些发现强调了探究与精神疾病相关的耻辱如何与其他污名化标签相互交织以产生独特的艾滋病毒风险状况的重要性。降低艾滋病毒风险的干预措施和预防研究应将注意力整合到患有严重精神疾病女性生活中被污名化的身份上。
