Chan Kit Yee, Yang Yi, Li Ze-rong, Stoové Mark A, Reidpath Daniel D
Nossal Institute for Global Health, University of Melbourne, Victoria, Australia.
Curr HIV Res. 2009 Nov;7(6):601-11. doi: 10.2174/157016209789973655.
Stigma within health care settings poses a considerable barrier to the provision of treatment and care for patients with HIV/AIDS (PLWHA). Southern China is located in a region with one of the world's fastest growing HIV/AIDS epidemics. Attitudes towards PLWHA amongst health workers are currently under-researched in this region. This paper examines the inter-relationships between prejudicial attitudes among Chinese medical students towards HIV/AIDS and attitudes towards three risk behaviors: injecting drug use (IDU), commercial sex (CS) and commercial blood donation (CBD). Medical students (N = 352) in Guangzhou were presented with two random vignettes; each describing a hypothetical male that was identical, except for the disease diagnosis (AIDS/leukemia) and the co-characteristic (IDU/CS/CBD/blood transfusion/no co-characteristic). After reading each vignette, participants completed a standard prejudicial scale. Univariate and multivariable analyses revealed significant levels of prejudice associated with AIDS, IDU and CS. Regardless of the disease, patients with IDU or CS were judged significantly worse than patients who had received a blood transfusion. No significant interactions were found between AIDS and the stigmatized co-characteristics. The findings suggest that prejudice towards PLWHA needs to be understood within the larger context of the stigma towards risk behaviors. Although non-significant interactions were found between AIDS and the stigmatized risk behaviors, the overlap between the local HIV/AIDS, IDU and CS populations suggests that addressing risk behavior-related prejudices could be critical for improving care and treatment for PLWHA.
医疗环境中的污名化现象对为艾滋病毒/艾滋病患者(PLWHA)提供治疗和护理构成了相当大的障碍。中国南方地区是世界上艾滋病毒/艾滋病疫情增长最快的地区之一。目前该地区卫生工作者对艾滋病毒/艾滋病患者的态度研究不足。本文探讨了中国医学生对艾滋病毒/艾滋病的偏见态度与对三种风险行为的态度之间的相互关系:注射吸毒(IDU)、商业性行为(CS)和商业献血(CBD)。广州的医学生(N = 352)被随机呈现两个 vignette;每个 vignette 描述一个假设的男性,除了疾病诊断(艾滋病/白血病)和共同特征(注射吸毒/商业性行为/商业献血/输血/无共同特征)外,其他方面都相同。阅读每个 vignette 后,参与者完成一个标准的偏见量表。单变量和多变量分析显示,与艾滋病、注射吸毒和商业性行为相关的偏见程度显著。无论疾病如何,有注射吸毒或商业性行为的患者被评判得比接受输血的患者明显更差。在艾滋病和被污名化的共同特征之间未发现显著的相互作用。研究结果表明,对艾滋病毒/艾滋病患者的偏见需要在对风险行为的污名化这一更大背景下理解。尽管在艾滋病和被污名化的风险行为之间未发现显著的相互作用,但当地艾滋病毒/艾滋病、注射吸毒和商业性行为人群之间的重叠表明,解决与风险行为相关的偏见对于改善对艾滋病毒/艾滋病患者的护理和治疗可能至关重要。