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高艾滋病病毒流行环境中与艾滋病病毒相关的社会排斥及危险性行为

HIV-related social intolerance and risky sexual behavior in a high HIV prevalence environment.

作者信息

Delavande Adeline, Sampaio Mafalda, Sood Neeraj

机构信息

Institute for Social and Economics Research, University of Essex, Colchester CO4 3SQ, UK; Nova School of Business and Economics, Universidade Nova de Lisboa, Campus de Campolide, 1099-032 Lisbon, Portugal.

Nova School of Business and Economics, Universidade Nova de Lisboa, Campus de Campolide, 1099-032 Lisbon, Portugal.

出版信息

Soc Sci Med. 2014 Jun;111:84-93. doi: 10.1016/j.socscimed.2014.04.011. Epub 2014 Apr 13.

Abstract

Although most countries state that fighting social intolerance against persons with HIV is part of their national HIV strategy, the impact of reducing intolerance on risky sexual behavior is largely unknown. In this paper, we estimate the effect of social intolerance against HIV+ persons on risky sexual behavior in rural Malawi using data from roughly 2000 respondents from the 2004 and 2006 waves of the Malawi Longitudinal Study of Families and Health (MLSFH). The effect of social intolerance on risky behavior is a priori ambiguous. On the one hand, higher social intolerance or stigma can lead people to disassociate from the stigmatized group and hence promote risky behavior. On the other hand, intolerance can be viewed as a social tax on being HIV+ and thus higher intolerance may reduce risky behavior. We find that a decrease in social intolerance is associated with a decrease in risky behavior, including fewer partners and a lower likelihood of having extra-marital relations. This effect is mainly driven by the impact of social intolerance on men. Overall the results suggests that reducing social intolerance might not only benefit the HIV positive but might also forestall the spread of HIV.

摘要

尽管大多数国家表示,打击对艾滋病毒感染者的社会排斥是其国家艾滋病毒战略的一部分,但减少排斥对危险性行为的影响在很大程度上尚不清楚。在本文中,我们利用马拉维家庭与健康纵向研究(MLSFH)2004年和2006年两轮调查中约2000名受访者的数据,估算了马拉维农村地区对艾滋病毒阳性者的社会排斥对危险性行为的影响。社会排斥对危险行为的影响在理论上是不明确的。一方面,更高的社会排斥或污名化会导致人们与被污名化群体脱离关系,从而助长危险行为。另一方面,排斥可被视为对感染艾滋病毒的一种社会代价,因此更高的排斥可能会减少危险行为。我们发现,社会排斥的减少与危险行为的减少相关,包括性伴侣减少和发生婚外情的可能性降低。这种影响主要是由社会排斥对男性的影响驱动的。总体而言,结果表明,减少社会排斥不仅可能使艾滋病毒阳性者受益,还可能防止艾滋病毒的传播。

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