艾滋病毒感染者的耻辱感、维权行动与幸福感

Stigma, activism, and well-being among people living with HIV.

作者信息

Earnshaw Valerie A, Rosenthal Lisa, Lang Shawn M

机构信息

a Center for Interdisciplinary Research on AIDS, Yale University , New Haven , CT , USA.

b Division of General Pediatrics, Department of Medicine , Boston Children's Hospital , Boston , MA , USA.

出版信息

AIDS Care. 2016;28(6):717-21. doi: 10.1080/09540121.2015.1124978. Epub 2016 Feb 6.

DOI:10.1080/09540121.2015.1124978

PMID:26852785

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC4950853/

Abstract

Evidence demonstrates that HIV stigma undermines the psychological and physical health of people living with HIV (PLWH). Yet, PLWH describe engaging in HIV activism to challenge stigma, and research suggests that individuals may benefit from activism. We examine associations between experiences of HIV stigma and HIV activism, and test whether HIV activists benefit from greater well-being than non-activists. Participants include 93 PLWH recruited from drop-in centers, housing programs, and other organizations providing services to PLWH in the Northeastern USA between 2012 and 2013 (mean age = 50 years; 56% Black, 20% White, 18% Other; 61% non-Latino(a), 39% Latino(a); 59% male, 38% female, 3% transgender; 82% heterosexual, 15% sexual minority). Participants completed a cross-sectional written survey. Results of regression analyses suggest that PLWH who experienced greater enacted stigma engaged in greater HIV activism. Anticipated, internalized, and perceived public stigma, however, were unrelated to HIV activism. Moreover, results of a multivariate analysis of variance suggest that HIV activists reported greater social network integration, greater social well-being, greater engagement in active coping with discrimination, and greater meaning in life than non-activists. Yet, HIV activists also reported somewhat greater depressive symptoms than non-activists, suggesting that the association between HIV activism and well-being is complex. By differentiating between HIV stigma mechanisms, the current study provides a more nuanced understanding of which experiences of HIV stigma may be associated with HIV activism. It further suggests that engagement in activism may offer benefits to PLWH, while raising the possibility that activists could experience greater depressive symptoms than non-activists. Given the preliminary nature of this study, future research should continue to examine these complex associations between HIV stigma, activism, and well-being among PLWH. As this work continues, PLWH, as well as interventionists and clinicians invested in improving well-being among PLWH, should carefully weigh the benefits and potential costs of activism.

摘要

有证据表明，对艾滋病病毒感染者的污名化会损害他们的身心健康。然而，艾滋病病毒感染者表示会参与艾滋病防治行动主义活动来挑战污名化现象，并且研究表明个人可能会从这类行动主义活动中受益。我们研究了艾滋病病毒污名化经历与艾滋病防治行动主义活动之间的关联，并测试艾滋病防治行动主义者是否比非行动主义者在幸福感方面受益更多。参与者包括2012年至2013年期间从美国东北部的救助中心、住房项目以及其他为艾滋病病毒感染者提供服务的组织招募的93名艾滋病病毒感染者（平均年龄 = 50岁；56%为黑人，20%为白人，18%为其他种族；61%为非拉丁裔，39%为拉丁裔；59%为男性，38%为女性，3%为跨性别者；82%为异性恋，15%为性少数群体）。参与者完成了一项横断面书面调查。回归分析结果表明，经历过更多实际污名化的艾滋病病毒感染者参与的艾滋病防治行动主义活动更多。然而，预期污名化、内化污名和感知到的公众污名与艾滋病防治行动主义活动无关。此外，方差多元分析结果表明，与非行动主义者相比，艾滋病防治行动主义者报告的社交网络融入度更高、社会幸福感更强、在积极应对歧视方面的参与度更高以及生活意义更强。然而，艾滋病防治行动主义者报告的抑郁症状也比非行动主义者略多，这表明艾滋病防治行动主义活动与幸福感之间的关联很复杂。通过区分艾滋病病毒污名化机制，本研究对哪些艾滋病病毒污名化经历可能与艾滋病防治行动主义活动相关提供了更细致入微的理解。研究还进一步表明，参与行动主义活动可能会给艾滋病病毒感染者带来益处，同时也增加了行动主义者可能比非行动主义者经历更严重抑郁症状的可能性。鉴于本研究的初步性质，未来的研究应继续探讨艾滋病病毒感染者中艾滋病病毒污名化、行动主义活动和幸福感之间的这些复杂关联。随着这项工作的持续推进，艾滋病病毒感染者以及致力于改善艾滋病病毒感染者幸福感的干预人员和临床医生应仔细权衡行动主义活动的益处和潜在成本。