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主观幸福感与 HIV 感染者的“主观”污名

Subjective wellbeing and ‘felt’ stigma when living with HIV.

机构信息

School of Political and Social Inquiry, Monash University, P.O. Box 197, Caulfield East, VIC, 3145, Australia.

出版信息

Qual Life Res. 2013 Feb;22(1):65-73. doi: 10.1007/s11136-012-0125-7.

Abstract

PURPOSE

The impact of stigma on subjective wellbeing was explored in adults living with HIV in Australia and the USA. It was hypothesised that this population would report poorer subjective wellbeing than the general population and that ‘felt’ stigma would contribute significantly to reported levels of subjective wellbeing.

METHODS

A total of 274 participants were recruited through Australian AIDS councils and HIV-specific online support groups. Participants completed a composite questionnaire comprising the personal wellbeing index—adult (PWI-A), the HIV version of the unsupportive social interactions inventory (USII) and demographic and health-related items. The PWI-A total score was used to form a personal wellbeing index, ranging from 0 to 100.

RESULTS

Participants reported mean PWI-A total scores of 54.7, considerably below the normative range of 70–80 for Western populations. There was a strong negative correlation between PWI-A total scores and USII total scores with the experience of high levels of unsupportive social interactions being associated with reduced levels of subjective wellbeing.

CONCLUSIONS

Our study suggests that despite antidiscrimination legislation, ‘felt’ stigma in the form of unsupportive social interactions continues to exert a negative impact on subjective wellbeing. Reduced subjective wellbeing may increase the risk of adverse health behaviours, such as medication non-adherence, substance abuse, risky sexual behaviours and non-disclosure of HIV serostatus.

摘要

目的

本研究旨在探讨在澳大利亚和美国生活的 HIV 感染者中,耻辱感对主观幸福感的影响。研究假设该人群的主观幸福感较一般人群差,且“感知到的”耻辱感对报告的主观幸福感水平有重要影响。

方法

通过澳大利亚艾滋病理事会和 HIV 特定的在线支持小组共招募了 274 名参与者。参与者完成了一个包含成人幸福感指数(PWI-A)、不支持性社会互动量表(USII)和人口统计学及健康相关项目的综合问卷。PWI-A 的总分用于形成一个幸福感指数,范围从 0 到 100。

结果

参与者报告的 PWI-A 总分平均为 54.7,明显低于西方人群 70-80 的正常范围。PWI-A 总分与 USII 总分之间呈强烈的负相关,与不支持性社会互动的经历相关,与主观幸福感水平降低有关。

结论

本研究表明,尽管有反歧视立法,但以不支持性社会互动形式存在的“感知到的”耻辱感继续对主观幸福感产生负面影响。主观幸福感的降低可能会增加不良健康行为的风险,如药物不依从、药物滥用、危险性行为和 HIV 血清学状态不披露。

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