Yi Siyan, Chhoun Pheak, Suong Samedy, Thin Kouland, Brody Carinne, Tuot Sovannary
Research Department, KHANA, Phnom Penh, Cambodia; Public Health Program, College of Education and Health Sciences, Touro University California, Vallejo, California, United States of America.
Research Department, KHANA, Phnom Penh, Cambodia.
PLoS One. 2015 Mar 25;10(3):e0121461. doi: 10.1371/journal.pone.0121461. eCollection 2015.
AIDS-related stigma and mental disorders are the most common conditions in people living with HIV (PLHIV). We therefore conducted this study to examine the association of AIDS-related stigma and discrimination with mental disorders among PLHIV in Cambodia.
A two-stage cluster sampling method was used to select 1,003 adult PLHIV from six provinces. The People Living with HIV Stigma Index was used to measure stigma and discrimination, and a short version of general health questionnaire (GHQ-12) was used to measure mental disorders. Multivariate logistic regression analysis was conducted.
The reported experiences of discrimination in communities in the past 12 months ranged from 0.8% for reports of being denied health services to 42.3% for being aware of being gossiped about. Internal stigma was also common ranging from 2.8% for avoiding going to a local clinic and/or hospital to 59.6% for deciding not to have (more) children. The proportions of PLHIV who reported fear of stigma and discrimination ranged from 13.9% for fear of being physically assaulted to 34.5% for fear of being gossiped about. The mean score of GHQ-12 was 3.2 (SD = 2.4). After controlling for several potential confounders, higher levels of mental disorders (GHQ-12≥ 4) remained significantly associated with higher levels of experiences of stigma and discrimination in family and communities (AOR = 1.9, 95% CI = 1.4-2.6), higher levels of internal stigma (AOR = 1.7, 95% CI = 1.2-2.3), and higher levels of fear of stigma and discrimination in family and communities (AOR = 1.5, 95% CI = 1.1-2.2).
AIDS-related stigma and discrimination among PLHIV in Cambodia are common and may have potential impacts on their mental health conditions. These findings indicate a need for community-based interventions to reduce stigma and discrimination in the general public and to help PLHIV to cope with this situation.
与艾滋病相关的耻辱感和精神障碍是艾滋病毒感染者（PLHIV）中最常见的情况。因此，我们开展了这项研究，以探讨柬埔寨艾滋病毒感染者中与艾滋病相关的耻辱感和歧视与精神障碍之间的关联。
采用两阶段整群抽样方法，从六个省份选取了1003名成年艾滋病毒感染者。使用艾滋病毒感染者耻辱感指数来衡量耻辱感和歧视，并使用简易一般健康问卷（GHQ-12）的简短版本来衡量精神障碍。进行了多变量逻辑回归分析。
在过去12个月中，报告的社区歧视经历范围从因被拒绝医疗服务的0.8%到因意识到被人议论的42.3%。内部耻辱感也很常见，范围从避免前往当地诊所和/或医院的2.8%到决定不（再）生育的59.6%。报告害怕耻辱感和歧视的艾滋病毒感染者比例范围从因害怕身体攻击的13.9%到因害怕被人议论的34.5%。GHQ-12的平均得分为3.2（标准差=2.4）。在控制了几个潜在混杂因素后，较高水平的精神障碍（GHQ-12≥4）仍然与家庭和社区中较高水平的耻辱感和歧视经历显著相关（比值比=1.9，95%置信区间=1.4-2.6），较高水平的内部耻辱感（比值比=1.7，95%置信区间=1.2-2.3），以及家庭和社区中较高水平的害怕耻辱感和歧视（比值比=1.5，95%置信区间=1.1-2.2）。
柬埔寨艾滋病毒感染者中与艾滋病相关的耻辱感和歧视很常见，可能对他们的心理健康状况产生潜在影响。这些发现表明需要开展基于社区的干预措施，以减少公众中的耻辱感和歧视，并帮助艾滋病毒感染者应对这种情况。
