Li Li, Lee Sung-Jae, Thammawijaya Panithee, Jiraphongsa Chuleeporn, Rotheram-Borus Mary Jane
Center for Community Health, Semel Institute, University of California, Los Angeles, CA, USA.
AIDS Care. 2009 Aug;21(8):1007-13. doi: 10.1080/09540120802614358.
People living with HIV/AIDS (PLWHA) in Thailand face tremendous challenges, including HIV-related stigma, lack of social support, and mental health issues such as depression. This study aims to examine complex relationships among demographics, HIV-related stigma, and social support and their impact on depression among PLWHA in Thailand.
This study uses data collected in northern and northeastern Thailand. A total of 408 PLWHA were recruited and interviewed in 2007. HIV-related stigma was measured by two subscales: "Internalized Shame" and "Perceived Stigma." Based on correlation analyses, hierarchical multiple regression models were used to examine the predictors of depression, social support, and HIV-related stigma, controlling for demographic characteristics.
Correlational analysis revealed that depression was significantly associated with both dimensions of stigma: internalized shame and perceived stigma. Self-reported emotional social support was negatively associated with depression. We found that internalized shame and emotional social support were significant predictors of depression after controlling for gender, age, income, and education.
HIV-related stigma has a negative impact on psychological wellbeing of PLWHA in Thailand, and emotional social support remains a protective factor against depression. Intervention developers and clinicians working with PLWHA may find it useful to incorporate the association between stigma and depression into their programs and treatments, and to address social support as a protective effect for the mental health of PLWHA.
泰国的艾滋病毒/艾滋病感染者面临着巨大挑战,包括与艾滋病毒相关的耻辱感、缺乏社会支持以及诸如抑郁等心理健康问题。本研究旨在探讨泰国艾滋病毒/艾滋病感染者的人口统计学特征、与艾滋病毒相关的耻辱感和社会支持之间的复杂关系及其对抑郁的影响。
本研究使用在泰国北部和东北部收集的数据。2007年共招募并采访了408名艾滋病毒/艾滋病感染者。通过两个子量表来衡量与艾滋病毒相关的耻辱感:“内化羞耻感”和“感知耻辱感”。基于相关性分析,使用分层多元回归模型来检验抑郁、社会支持和与艾滋病毒相关的耻辱感的预测因素,并控制人口统计学特征。
相关性分析表明,抑郁与耻辱感的两个维度均显著相关:内化羞耻感和感知耻辱感。自我报告的情感社会支持与抑郁呈负相关。我们发现,在控制了性别、年龄、收入和教育程度后,内化羞耻感和情感社会支持是抑郁的显著预测因素。
与艾滋病毒相关的耻辱感对泰国艾滋病毒/艾滋病感染者的心理健康有负面影响,而情感社会支持仍然是预防抑郁的保护因素。为艾滋病毒/艾滋病感染者提供干预措施的人员和临床医生可能会发现,将耻辱感与抑郁之间的关联纳入他们的项目和治疗中,并将社会支持作为艾滋病毒/艾滋病感染者心理健康的保护效应来加以解决是有用的。