Li Zhen, Hsieh Evelyn, Morano Jamie P, Sheng Yu
a School of Nursing , Peking Union Medical College , Beijing , People's Republic of China.
b Department of Internal Medicine , Yale School of Medicine , New Haven , CT , USA.
AIDS Care. 2016 Nov;28(11):1394-401. doi: 10.1080/09540121.2016.1179713. Epub 2016 May 3.
Human immunodeficiency virus (HIV)-related stigma among HIV-infected men who have sex with men (MSM) has been associated with adverse health outcomes, including poor adherence to antiretroviral therapy and care, and increased participation in behaviors linked to higher rates of HIV transmission. In China, the incidence of HIV is growing more rapidly among MSM than among other subgroups. This study characterizes and quantifies HIV stigma among HIV-infected MSM in Beijing, China, which arguably may be driving this epidemic. A cross-sectional survey study was performed among 266 HIV-positive MSM in Beijing, China, in 2014. The Berger HIV Stigma Scale was used to measure levels of HIV-related stigma. Participants additionally answered questions regarding socio-demographic characteristics and HIV-associated risk factors; previously validated Mandarin-language scales assessed depression, coping style, and social support networks. Multivariable linear regression models were used to identify variables significantly associated with HIV stigma. The mean overall HIV stigma score among the study population was 112.78 ± 18.11 (score range: 40-160). Higher HIV stigma scores were positively associated with depression (β = 7.99, 95% CI:3.69, 12.29, p < .001) and negative coping skills (β = 0.64, 95% CI:0.21,1.08, p < .01), and was negatively associated with disclosed HIV status (β = -6.45, 95%CI:-11.80, -1.11, p < .05), and availability of social support networks (β = -0.12, 95%CI:-0.22, -0.02, p < .05). Other variables such as poor self-rated health status and presence of opportunistic infections were positively associated with individual dimensions of HIV-related stigma. The results of this study can inform the development of culturally sensitive interventions to reduce HIV-related stigma among MSM with HIV in China, with the overarching goal of reducing HIV transmission in this vulnerable population.
在男男性行为者(MSM)中,感染人类免疫缺陷病毒(HIV)相关的耻辱感与不良健康后果相关,包括对抗逆转录病毒疗法和护理的依从性差,以及增加参与与更高HIV传播率相关行为的可能性。在中国,MSM中HIV的发病率增长速度比其他亚群体更快。本研究对中国北京感染HIV的MSM中的HIV耻辱感进行了特征描述和量化,这可能是导致这一流行病的原因。2014年,在中国北京对266名HIV阳性MSM进行了一项横断面调查研究。使用伯杰HIV耻辱感量表来测量与HIV相关的耻辱感水平。参与者还回答了有关社会人口特征和HIV相关危险因素的问题;先前经过验证的中文量表评估了抑郁、应对方式和社会支持网络。使用多变量线性回归模型来确定与HIV耻辱感显著相关的变量。研究人群中HIV耻辱感的总体平均得分是112.78±18.11(得分范围:40 - 160)。较高的HIV耻辱感得分与抑郁(β = 7.99,95%置信区间:3.69,12.29,p <.001)和消极应对技能(β = 0.64,95%置信区间:0.21,1.08,p <.01)呈正相关,与披露HIV感染状况(β = -6.45,95%置信区间:-11.80,-1.11,p <.05)和社会支持网络的可获得性(β = -0.12,95%置信区间:-0.22,-0.02,p <.05)呈负相关。其他变量,如自我评估健康状况差和存在机会性感染,与HIV相关耻辱感的各个维度呈正相关。本研究结果可为制定具有文化敏感性的干预措施提供参考,以减少中国感染HIV的MSM中与HIV相关的耻辱感,总体目标是减少这一弱势群体中的HIV传播。