乌干达农村地区的内化耻辱感、社会距离与艾滋病毒血清阳性状况的披露
Internalized stigma, social distance, and disclosure of HIV seropositivity in rural Uganda.
作者信息
Tsai Alexander C, Bangsberg David R, Kegeles Susan M, Katz Ingrid T, Haberer Jessica E, Muzoora Conrad, Kumbakumba Elias, Hunt Peter W, Martin Jeffrey N, Weiser Sheri D
机构信息
Chester M. Pierce, MD Division of Global Psychiatry, Department of Psychiatry, Massachusetts General Hospital (MGH), Boston, MA, USA,
出版信息
Ann Behav Med. 2013 Dec;46(3):285-94. doi: 10.1007/s12160-013-9514-6.
Abstract
BACKGROUND
HIV is highly stigmatized, compromising both treatment and prevention in resource-limited settings.
PURPOSE
We sought to study the relationship between internalized HIV-related stigma and serostatus disclosure and to determine the extent to which this association varies with the degree of social distance.
METHODS
We fit multivariable Poisson regression models, with cluster-correlated robust estimates of variance, to data from 259 persons with HIV enrolled in an ongoing cohort study in rural Uganda.
RESULTS
Persons with more internalized stigma were less likely to disclose their seropositivity. The magnitude of association increased with social distance such that the largest association was observed for public disclosures and the smallest association was observed for disclosures to sexual partners.
CONCLUSIONS
Among persons with HIV in rural Uganda, internalized stigma was negatively associated with serostatus disclosure. The inhibiting effect of stigma was greatest for the most socially distant ties.
摘要
背景
艾滋病毒受到高度污名化，这在资源有限的环境中对治疗和预防均造成了不利影响。
目的
我们试图研究内化的与艾滋病毒相关的污名与血清学状态披露之间的关系，并确定这种关联随社会距离程度变化的程度。
方法
我们对乌干达农村地区正在进行的一项队列研究中登记的259名艾滋病毒感染者的数据，拟合了具有聚类相关稳健方差估计的多变量泊松回归模型。
结果
内化污名程度较高的人披露其血清阳性的可能性较小。关联程度随社会距离增加而增大，因此在公开披露中观察到的关联最大，而在向性伴侣披露中观察到的关联最小。
结论
在乌干达农村的艾滋病毒感染者中，内化污名与血清学状态披露呈负相关。污名的抑制作用在社会距离最远的关系中最为明显。
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