Steward Wayne T, Bharat Shalini, Ramakrishna Jayashree, Heylen Elsa, Ekstrand Maria L
Center for AIDS Prevention Studies, University of California, San Francisco, San Francisco, CA 94105, USA.
J Int Assoc Provid AIDS Care. 2013 Mar-Apr;12(2):103-9. doi: 10.1177/1545109711432315. Epub 2012 Jan 26.
Stigma shapes the lives of people living with HIV and may affect their willingness to seek medical care. But treatment delays can compromise health and increase the risk of transmission to others.
To examine whether the 4 stigma manifestations--enacted (discrimination), vicarious (hearing stories of discrimination), felt normative (perceptions of stigma's prevalence), and internalized (personal endorsement of stigma beliefs)--were linked with delays in seeking care among HIV-infected people in India.
A cross-sectional survey was conducted with 961 HIV-positive men and women in Mumbai and Bengaluru.
Enacted and internalized stigmas were correlated with delays in seeking care after testing HIV positive. Depression symptoms mediated the associations of enacted and internalized stigmas with care-seeking delays, whereas efforts to avoiding disclosing HIV status mediated only the association between internalized stigma and care-seeking delays.
It is vital to develop stigma reduction interventions to ensure timely receipt of care.
耻辱感影响着艾滋病毒感染者的生活，并可能影响他们寻求医疗护理的意愿。但治疗延迟会损害健康并增加传染给他人的风险。
研究四种耻辱感表现形式——遭受的（歧视）、替代性的（听闻歧视故事）、感知到的规范性的（对耻辱感普遍程度的认知）和内化的（对耻辱感信念的个人认同）——是否与印度艾滋病毒感染者寻求护理的延迟有关。
在孟买和班加罗尔对961名艾滋病毒呈阳性的男性和女性进行了横断面调查。
遭受的耻辱感和内化的耻辱感与艾滋病毒检测呈阳性后寻求护理的延迟相关。抑郁症状介导了遭受的耻辱感和内化的耻辱感与寻求护理延迟之间的关联，而避免披露艾滋病毒感染状况的行为仅介导了内化的耻辱感与寻求护理延迟之间的关联。
开展减少耻辱感的干预措施对于确保及时获得护理至关重要。
