Malavé S, Ramakrishna J, Heylen E, Bharat S, Ekstrand M L
a Department of Medicine, Center for AIDS Prevention Studies , University of California , San Francisco , CA 94105 , USA.
AIDS Care. 2014;26(3):396-403. doi: 10.1080/09540121.2013.819409. Epub 2013 Jul 22.
Approximately 2.4 million people in India are living with HIV. Gender inequality affects HIV prevention, detection, and management. The purpose of this paper was to describe gender differences in the experience of living with HIV in Bengaluru, India. A subsample of n = 313 (159 men and 154 women) from a larger cohort was used for these analyses. Participants were recruited through AIDS service organizations. They completed an interviewer-administered survey assessing HIV testing experience, types of stigma, and perceived consequences of stigmatization. The majority of men (67%) reported getting HIV tested because of illness, while women were more likely to be tested after learning their spouse's HIV-positive status (42%). More men (59%) than women (45%, p<0.05) were tested in private care settings. Men reported significantly higher mean levels of internalized stigma (men: M=0.71, SD = 0.63; women: M=0.46, SD = 0.55; p<0.001), whereas the women reported significantly higher scores for enacted stigma (men: M=1.30, SD = 1.69; women: M=2.10, SD = 2.17; p<0.001). These differences remained significant after controlling for potential socio-demographic covariates. Following their diagnosis, more women reported moving out of their homes (men: 16%; women: 26%; p<0.05). More men (89%) than women (66%; p<0.001) reported to have modified their sexual behavior after being diagnosed. These findings suggest that the experience of living with HIV and HIV stigma varies by gender in this population. Suggestions for a gender-based approach to HIV prevention and stigma reduction are provided.
印度约有240万人感染了艾滋病毒。性别不平等影响着艾滋病毒的预防、检测和管理。本文旨在描述印度班加罗尔艾滋病毒感染者经历中的性别差异。这些分析使用了来自一个更大队列的n = 313人的子样本（159名男性和154名女性）。参与者通过艾滋病服务组织招募。他们完成了一项由访谈员进行的调查，评估艾滋病毒检测经历、耻辱类型以及耻辱感的感知后果。大多数男性（67%）报告因患病而进行艾滋病毒检测，而女性在得知配偶艾滋病毒呈阳性后更有可能接受检测（42%）。在私人护理机构接受检测的男性（59%）多于女性（45%，p<0.05）。男性报告的内化耻辱感平均水平显著更高（男性：M = 0.71，SD = 0.63；女性：M = 0.46，SD = 0.55；p<0.001），而女性报告的表现出的耻辱感得分显著更高（男性：M = 1.30，SD = 1.69；女性：M = 2.10，SD = 2.17；p<0.001）。在控制了潜在的社会人口统计学协变量后，这些差异仍然显著。确诊后，更多女性报告搬离了家（男性：16%；女性：26%；p<0.05）。报告在确诊后改变性行为的男性（89%）多于女性（66%；p<0.001）。这些发现表明，在这一人群中，艾滋病毒感染者的经历和艾滋病毒耻辱感因性别而异。本文还提供了基于性别的艾滋病毒预防和减少耻辱感方法的建议。
