Dartmouth Medical School, Hanover, New Hampshire, USA.
Health Soc Care Community. 2011 Sep;19(5):541-9. doi: 10.1111/j.1365-2524.2011.01002.x. Epub 2011 May 4.
The shortage of healthcare workers caring for South Africa's 5-6 million persons living with HIV/AIDS (PLHA) calls for inquiry into workers' challenges and experiences. This exploratory study examines one little-studied challenge: stigmatisation of HIV/AIDS healthcare workers based on their association with PLHA. The authors tested the hypotheses that HIV/AIDS healthcare workers experience stigmatisation due to their association with PLHA, and that such association stigma is correlated with thoughts of leaving the HIV/AIDS field. A sample of 100 participants who provided direct care to PLHA was recruited from a variety of public and private HIV/AIDS care centres in Eastern Cape province, South Africa. Participants attended one of 12 focus groups held between June and August, 2008. They completed a 17-item questionnaire and discussed each item. Findings exhibit the presence of an adverse differentiation and labelling of HIV/AIDS healthcare workers, leading to status loss and discrimination, creating an impetus for HIV/AIDS healthcare workers to leave AIDS work altogether. A significant relationship (χ(2) (TREND) = 3.86, df = 1, P = 0.049) was found between contemplation of leaving AIDS work and perception of others' responses to their work with PLHA. In addition, associations emerged between type of AIDS worker and contemplation of working in AIDS care outside of South Africa (Kruskal-Wallis χ(2) = 6.96, df = 2, P = 0.031), with doctors and nurses reporting higher frequency of contemplating leaving South Africa to work with PLHA elsewhere (Mann-Whitney z = -2.53, P = 0.011). The study lays the foundation for additional research on the effects of association stigma. In turn, increased efforts to retain and recruit new HIV/AIDS healthcare workers will expand the pool of healthcare personnel to PLHA.
南非有 500 到 600 万艾滋病毒/艾滋病患者（PLHA），医护人员短缺，因此有必要调查医护人员所面临的挑战和体验。本探索性研究考察了一个鲜少被研究的挑战：因与 PLHA 相关联而对艾滋病毒/艾滋病医护人员的污名化。作者检验了以下两个假设：由于与 PLHA 相关联，艾滋病毒/艾滋病医护人员会受到污名化，并且这种关联污名与离开艾滋病毒/艾滋病领域的想法相关。作者从南非东开普省的各种公立和私立艾滋病毒/艾滋病护理中心招募了 100 名直接为 PLHA 提供护理的参与者。参与者参加了 2008 年 6 月至 8 月间举行的 12 次焦点小组中的一次。他们完成了一份包含 17 个项目的问卷，并对每个项目进行了讨论。研究结果显示，艾滋病毒/艾滋病医护人员遭受了不利的区分和污名化，导致其地位丧失和歧视，这促使艾滋病毒/艾滋病医护人员完全离开艾滋病工作。研究还发现，考虑离开艾滋病工作与对他人对其与 PLHA 工作的反应的看法之间存在显著关系（χ(2) (TREND) = 3.86, df = 1, P = 0.049）。此外，还发现艾滋病医护人员的类型与考虑在南非以外的艾滋病护理工作之间存在关联（Kruskal-Wallis χ(2) = 6.96, df = 2, P = 0.031），医生和护士报告称更频繁地考虑离开南非到其他地方为 PLHA 工作（Mann-Whitney z = -2.53, P = 0.011）。该研究为关联污名化影响的进一步研究奠定了基础。反过来，为留住和招募新的艾滋病毒/艾滋病医护人员而做出更多努力将扩大为 PLHA 提供医疗保健的人员队伍。
