Radcliffe Sheldon, Neaigus Alan, Bernard Marie Antoinette, Shepard Colin
a HIV Epidemiology & Field Services Program, New York City Department of Health and Mental Hygiene , Long Island City , NY , USA.
AIDS Care. 2015;27(9):1156-61. doi: 10.1080/09540121.2015.1034647. Epub 2015 Apr 27.
This analysis used data from a randomly selected cross-sectional sample of HIV infected outpatient adults in New York City to assess HIV-related stigma and examine gender-specific differences among factors associated with HIV-related stigma. Data was collected by conducting participant interviews and medical records abstraction. HIV-related stigma was assessed using the internalized AIDS-related stigma scale (IA-RSS). Exploratory factor analysis of the IA-RSS indicated that the scale consisted of two factors: (1) internalized stigma and (2) anticipated stigma. Of the 447 sampled participants 23.9% had a higher level of internalized stigma and 38.3% had a higher level of anticipated stigma. Multivariate analysis indicated that among females, internalized stigma was associated with being diagnosed HIV positive after the introduction of HAART in 1996 (adjusted prevalence ratio [PR]: 1.9; 95% CI: 1.2, 3.1; P < 0.01) and a diagnosis of depression (adjusted PR: 1.9; 95% CI: 1.2, 2.9; P < 0.01). Among males, anticipated stigma was associated with younger age (18 and 39 years) (adjusted PR: 1.7; 95% CI: 1.3, 2.2; P < 0.001) and use of non-injection drugs (adjusted PR: 0.60; 95% CI: 0.41, 0.86; P < 0.01). Findings suggest that there may be gender-specific differences among factors associated with different dimensions of HIV-related stigma.
该分析使用了从纽约市随机抽取的感染HIV的门诊成年患者横断面样本数据,以评估与HIV相关的耻辱感,并研究与HIV相关耻辱感相关因素中的性别差异。通过进行参与者访谈和提取医疗记录来收集数据。使用内化艾滋病相关耻辱感量表(IA-RSS)评估与HIV相关的耻辱感。对IA-RSS的探索性因素分析表明,该量表由两个因素组成:(1)内化耻辱感和(2)预期耻辱感。在447名抽样参与者中,23.9%的人内化耻辱感水平较高,38.3%的人预期耻辱感水平较高。多变量分析表明,在女性中,内化耻辱感与1996年高效抗逆转录病毒治疗(HAART)引入后被诊断为HIV阳性有关(调整患病率比[PR]:1.9;95%置信区间:1.2,3.1;P<0.01),还与抑郁症诊断有关(调整PR:1.9;95%置信区间:1.2,2.9;P<0.01)。在男性中,预期耻辱感与年龄较轻(18至39岁)有关(调整PR:1.7;95%置信区间:1.3,2.2;P<0.001),还与使用非注射类药物有关(调整PR:0.60;95%置信区间:0.41,0.86;P<0.01)。研究结果表明,与HIV相关耻辱感不同维度相关的因素可能存在性别差异。