Ding Yingying, Li Li, Ji Guoping
Center for Community Health, Semel Institute for Neuroscience and Human Behavior, University of California at Los Angeles, USA.
AIDS Care. 2011 Sep;23(9):1059-66. doi: 10.1080/09540121.2011.554524. Epub 2011 Jun 1.
This study examined the main reasons and predictors of HIV disclosure and its relationship to access to care among people living with HIV (PLH) in a rural area of China. A sample of 88 PLH from three counties was interviewed in 2009. In our sample, the rates of disclosure were higher within and outside family. Trust (31%), needing help (28%), and close relationships (26%) were the three main reasons of selecting the person to disclose by a PLH. Using a multivariate analysis, level of HIV disclosure to partners and members within the community was only significantly associated with use of antiretroviral treatment (ART) (β = 2.76; 95% Confidence Interval (CI): 0.77, 4.74). After adjusting for demographics, time since HIV diagnosis and ART, we found HIV disclosure (β = 0.07; 95% CI: 0.01, 0.13) was a significant predictor for access to care. In order to improve PLHs' access to health services and care, future intervention programs should consider both the potential benefits and risks associated with HIV disclosure (intentional and unintentional), and assist PLHs to prepare for HIV disclosure and reduce potential negative impacts that come with it.
本研究调查了中国农村地区艾滋病病毒感染者（PLH）披露艾滋病病毒感染情况的主要原因和预测因素，及其与获得医疗服务的关系。2009年，对来自三个县的88名艾滋病病毒感染者进行了抽样访谈。在我们的样本中，在家庭内部和外部披露感染情况的比例较高。信任（31%）、需要帮助（28%）和亲密关系（26%）是艾滋病病毒感染者选择披露感染情况对象的三个主要原因。通过多变量分析，向伴侣和社区成员披露艾滋病病毒感染情况的程度仅与抗逆转录病毒治疗（ART）的使用显著相关（β = 2.76；95%置信区间（CI）：0.77，4.74）。在对人口统计学、艾滋病病毒诊断后的时间和抗逆转录病毒治疗进行调整后，我们发现艾滋病病毒感染情况的披露（β = 0.07；95% CI：0.01，0.13）是获得医疗服务的一个显著预测因素。为了改善艾滋病病毒感染者获得卫生服务和医疗护理的机会，未来的干预项目应考虑与艾滋病病毒感染情况披露（有意和无意）相关的潜在益处和风险，并协助艾滋病病毒感染者为披露感染情况做好准备，减少随之而来的潜在负面影响。
