1 Department of Public Health, Institute of Tropical Medicine , Antwerp, Belgium .
AIDS Patient Care STDS. 2014 Mar;28(3):155-61. doi: 10.1089/apc.2013.0247. Epub 2014 Feb 25.
This cross-sectional European study assessed self-reported HIV-related discrimination and its associated factors in health care settings. Socio-demographics, health status, support needs relating to sexual and reproductive health (SRH), and self-reported HIV-related discrimination were measured using an anonymous survey in a sample of 1549 people living with HIV from 14 countries. Thirty-two per cent of the participants had experienced HIV-related discrimination during the previous 3 years; almost half of them felt discriminated against by health care providers. For this type of discrimination, logistic regression analysis revealed significant associations with not being a migrant (OR: 2.0; IC 1.0-3.7; p<0.05), having been forced into sexual activities (OR: 1.6; IC 1.2-2.2; p<0.001), reporting lack of time to discuss SRH during service provision (OR: 1.7; IC 1.0-2.7; p<0.05), and insufficient openness among service providers to discuss SRH (OR: 2.0; IC 1.1-3.4; p<0.05). Other significant associations related to unmet support needs on safer sex practices (OR: 1.8; IC 1.0-3.2; p<0.05), partner communication about sexuality (OR: 2.0; IC 1.1-3.4; p<0.05), and prevention of sexually transmitted infections (OR: 1.7; IC 1.0-3.0; p<0.05). Female gender had a protective effect (OR: 0.2; IC 0.0-0.9; p<0.05). Being denied the opportunity to discuss SRH may translate in feelings of discrimination. Improving health care providers' communication skills, and fostering openness about SRH topics in HIV care could contribute to destigmatization of PLHIV.
这项欧洲的横断面研究评估了在医疗环境中自我报告的与艾滋病毒相关的歧视及其相关因素。在来自 14 个国家的 1549 名艾滋病毒感染者样本中,使用匿名调查评估了社会人口统计学、健康状况、与性和生殖健康相关的支持需求以及自我报告的与艾滋病毒相关的歧视。在过去 3 年中,32%的参与者经历过与艾滋病毒相关的歧视;其中近一半人感到受到医疗保健提供者的歧视。对于这种类型的歧视,逻辑回归分析显示与以下因素显著相关:非移民(OR:2.0;1.0-3.7;p<0.05)、被迫发生性行为(OR:1.6;1.2-2.2;p<0.001)、报告在服务提供期间没有时间讨论性和生殖健康(OR:1.7;1.0-2.7;p<0.05)以及服务提供者对讨论性和生殖健康的开放程度不足(OR:2.0;1.1-3.4;p<0.05)。其他与未满足的安全性行为实践支持需求(OR:1.8;1.0-3.2;p<0.05)、伴侣之间关于性的沟通(OR:2.0;1.1-3.4;p<0.05)和预防性传播感染(OR:1.7;1.0-3.0;p<0.05)相关的重要关联。女性性别具有保护作用(OR:0.2;0.0-0.9;p<0.05)。被剥夺讨论性和生殖健康的机会可能会导致歧视感。提高医疗保健提供者的沟通技巧,促进艾滋病毒护理中对性和生殖健康主题的开放态度,有助于减少对艾滋病毒感染者的污名化。