Li Li, Lin Chunqing, Wu Zunyou, Scott Comulada W, Ding Yingying
Semel Institute, Center for Community Health, University of California at Los Angeles, Los Angeles, CA 90024, USA.
Soc Sci Med. 2012 Jul;75(2):283-7. doi: 10.1016/j.socscimed.2012.02.054. Epub 2012 Apr 12.
We examined the relationships between a region's HIV prevalence and HIV-related knowledge, perceived risk of HIV infection, perceived institutional support for HIV care, and avoidance attitude toward persons living with HIV (PLH) among service providers in China. Data were collected from 40 county-level hospitals in two provinces, including 1760 service providers. Multi-sample standardization and decomposition analysis was performed for HIV knowledge, perceived risk, institutional support, and avoidance attitude toward PLH. After adjusting for potential confounders, service providers from the province with higher HIV prevalence perceived a higher risk of contracting HIV at work, recognized more institutional support for HIV care, and reported a lower level of avoidance attitude toward PLH compared to those from the province with lower HIV prevalence. After confounding factors were standardized across provinces, occupational exposure experience was determined to be the strongest influence on the discrepancy of avoidance attitudes in the two provinces. Regional contextual factors could shape individual providers' attitudes and beliefs and impact the quality of care. Stigma reduction interventions need to be culturally tailored and region-specific.
我们研究了中国服务提供者所在地区的艾滋病毒流行率与艾滋病毒相关知识、感知到的艾滋病毒感染风险、对艾滋病毒护理的机构支持感知以及对艾滋病毒感染者（PLH）的回避态度之间的关系。数据来自两个省份的40家县级医院，包括1760名服务提供者。对艾滋病毒知识、感知风险、机构支持以及对艾滋病毒感染者的回避态度进行了多样本标准化和分解分析。在调整潜在混杂因素后，与艾滋病毒流行率较低省份的服务提供者相比，艾滋病毒流行率较高省份的服务提供者认为在工作中感染艾滋病毒的风险更高，认识到更多对艾滋病毒护理的机构支持，并且报告对艾滋病毒感染者的回避态度较低。在各省对混杂因素进行标准化后，职业暴露经历被确定为对两省回避态度差异影响最大的因素。区域背景因素可能塑造个体提供者的态度和信念，并影响护理质量。减少耻辱感干预措施需要根据文化特点进行调整并因地制宜。
