Maluccio John A, Wu Fan, Rokon Redwan B, Rawat Rahul, Kadiyala Suneetha
Department of Economics, Middlebury College, 14 Old Chapel Road, Middlebury, VT, 05753, USA.
Poverty, Health, and Nutrition Division, International Food Policy Research Institute (IFPRI), Dakar, Senegal.
AIDS Behav. 2017 Mar;21(3):766-782. doi: 10.1007/s10461-016-1476-9.
HIV-related stigma among persons living with HIV/AIDS (PLHIV) is prevalent throughout sub-Saharan Africa. There is limited evidence, however, on which interventions are effective in reducing it. We used data from a prospective impact evaluation of a 12-month food assistance intervention among 904 antiretroviral therapy (ART)- naïve PLHIV in Uganda to examine the program impact on stigma. Stigma was measured using the comprehensive HASI-P scale, which demonstrated good internal consistency (Cronbach's alpha = 0.87) and was correlated with several related constructs including physical and mental health-related quality of life, disclosure, and physical health symptoms in the sample. Using quasi-experimental difference-in-difference matching methods to better infer causality, we tested whether the intervention improved the overall stigma scale and its subscales. The food assistance intervention had a significant effect on reported internalized (but not external) stigma of approximately 0.2 SD (p < 0.01). The HASI-P stigma scale is a useful tool for measuring and tracking stigma. Food assistance interventions, embedded in an HIV care program, can reduce internalized stigma.
在撒哈拉以南非洲地区，艾滋病毒/艾滋病感染者（PLHIV）中与艾滋病毒相关的污名化现象普遍存在。然而，关于哪些干预措施能有效减少这种污名化现象的证据有限。我们利用乌干达904名未接受过抗逆转录病毒治疗（ART）的艾滋病毒感染者参与的一项为期12个月的粮食援助干预措施的前瞻性影响评估数据，来检验该项目对污名化现象的影响。污名化程度通过综合HASI-P量表进行测量，该量表具有良好的内部一致性（克朗巴哈系数α = 0.87），并且与样本中的几个相关指标相关，包括与身心健康相关的生活质量、信息披露以及身体健康症状。我们使用准实验性差异匹配法来更好地推断因果关系，测试该干预措施是否改善了整体污名化量表及其子量表。粮食援助干预措施对报告的内化污名（而非外在污名）产生了显著影响，约为0.2个标准差（p < 0.01）。HASI-P污名化量表是测量和追踪污名化现象的有用工具。纳入艾滋病毒护理项目的粮食援助干预措施可以减少内化污名。
