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法国艾滋病毒感染者向性伴侣以外的人披露艾滋病毒感染状况:是在寻求帮助吗?法国国家横断面调查ANRS-VESPA2的结果

Disclosure of HIV Status Beyond Sexual Partners by People Living with HIV in France: A Call for Help? Results from the National Cross-Sectional Survey ANRS-VESPA2.

作者信息

Marcellin Fabienne, Suzan-Monti Marie, Vilotitch Antoine, Sagaon-Teyssier Luis, Mora Marion, Dray-Spira Rosemary, Préau Marie, Lert France, Spire Bruno

机构信息

Aix Marseille Univ, INSERM, IRD, SESSTIM, Sciences Economiques & Sociales de la Santé & Traitement de l'Information Médicale, Marseille, France.

ORS PACA, Observatoire régional de la santé Provence-Alpes-Côte d'Azur, Marseille, France.

出版信息

AIDS Behav. 2017 Jan;21(1):196-206. doi: 10.1007/s10461-016-1549-9.

Abstract

HIV status disclosure remains a complex issue for most people living with HIV (PLWH). We analyzed PLWH disclosure behaviors in France, where treatment is free and where the social image of HIV has improved in the general population. Analyses focused on disclosure to the social network excluding sexual partners (close family, other relatives, friends, colleagues). The study sample comprised 3016 participants from the nationally representative survey ANRS-VESPA2. Three PLWH clusters were identified using hierarchical classification ("high disclosure level": 28.2 %, "medium disclosure level": 27.5 %, and "low disclosure level": 44.3 %). In multivariable analyses, the variable "not living in a couple but psychological social support needed" was independently associated with medium (AOR [95 % CI] 1.8 [1.4; 2.3]) and high levels of disclosure (1.4 [1.1; 1.8]) (multinomial regression models). For PLWH living alone, HIV status disclosure may reveal a need for psychological social support, a key component to treatment adherence and positive prevention.

摘要

对于大多数艾滋病毒感染者(PLWH)来说,披露艾滋病毒感染状况仍然是一个复杂的问题。我们分析了法国艾滋病毒感染者的披露行为,在法国,治疗是免费的,而且艾滋病毒在普通人群中的社会形象有所改善。分析重点是向不包括性伴侣在内的社交网络(亲密家人、其他亲属、朋友、同事)披露情况。研究样本包括来自具有全国代表性的调查ANRS-VESPA2的3016名参与者。使用层次分类法确定了三类艾滋病毒感染者(“高披露水平”:28.2%,“中等披露水平”:27.5%,“低披露水平”:44.3%)。在多变量分析中,“未处于伴侣关系但需要心理社会支持”这一变量与中等(调整后比值比[AOR][95%置信区间]为1.8[1.4;2.3])和高披露水平(1.4[1.1;1.8])独立相关(多项回归模型)。对于独居的艾滋病毒感染者来说,披露艾滋病毒感染状况可能表明需要心理社会支持,这是治疗依从性和积极预防的关键组成部分。

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