Vorasane Savina, Jimba Masamine, Kikuchi Kimiyo, Yasuoka Junko, Nanishi Keiko, Durham Jo, Sychareun Vanphanom
Department of Radiology, Mahosoth hospital, Vientiane, Lao PDR.
Department of Community and Global Health, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
BMC Health Serv Res. 2017 Feb 10;17(1):125. doi: 10.1186/s12913-017-2068-8.
Despite global efforts, HIV-related stigma continues to negatively impact the health and well-being of people living with HIV/AIDS. Even in healthcare settings, people with HIV/AIDS experience discrimination. Anecdotal evidence suggests that healthcare professionals in the Lao People's Democratic Republic, a lower-middle income country situated in Southeast Asia, stigmatize HIV/AID patients. The purpose of this study was to assess HIV stigmatizing attitudes within Laotian healthcare service providers and examine some of the factors associated with HIV/AIDS-related stigma among doctors and nurses.
A structured questionnaire, which included a HIV-related stigma scale consisting of 17 items, was self-completed by 558 healthcare workers from 12 of the 17 hospitals in Vientiane. Five hospitals were excluded because they had less than 10 staff and these staff were not always present. The questionnaire was pre-tested with 40 healthcare workers. Descriptive statistical analysis was performed and comparisons between groups undertaken using chi-square test and t-test. Bivariate and multiple linear regression analyses were carried out to examine the associations between stigmatizing attitudes and independent variables.
Out of the 558 participating healthcare workers, 277 (49.7%) were doctors and 281 (50.3%) were nurses. Nearly 50% of doctors and nurses included in the study had high levels of stigmatizing attitudes towards people living with HIV/AIDS. Across the different health professionals included in this study, lower levels of HIV/AIDS knowledge were associated with higher levels of stigmatizing attitudes towards people living with HIV/AIDS. Stigmatizing attitudes, including discrimination at work, fear of AIDS, and prejudice, were lower in healthcare workers with more experience in treating HIV/AIDS patients.
This study is the first to report on HIV/AIDS-related stigmatization among healthcare workers in Lao PDR. Stigmatizing attitudes contribute to missed opportunities for prevention, education and treatment, undermining efforts to manage and prevent HIV. Reversing stigmatizing attitudes and practices requires interventions that address affective, cognitive and behavioral aspects of stigma. Alongside this, health professionals need to be enabled to enact universal precautions and prevent occupational transmission of HIV.
尽管全球都在努力，但与艾滋病毒相关的污名化继续对艾滋病毒/艾滋病感染者的健康和福祉产生负面影响。即使在医疗环境中，艾滋病毒/艾滋病感染者也会遭受歧视。轶事证据表明，位于东南亚的中低收入国家老挝人民民主共和国的医疗保健专业人员会歧视艾滋病毒/艾滋病患者。本研究的目的是评估老挝医疗服务提供者中对艾滋病毒的污名化态度，并研究医生和护士中与艾滋病毒/艾滋病相关污名化有关的一些因素。
一份结构化问卷，其中包括一个由17个项目组成的与艾滋病毒相关的污名化量表，由万象17家医院中12家医院的558名医护人员自行填写。五家医院被排除，因为它们的工作人员少于10人，而且这些工作人员并非总是在岗。该问卷在40名医护人员中进行了预测试。进行了描述性统计分析，并使用卡方检验和t检验对组间进行了比较。进行了双变量和多元线性回归分析，以检验污名化态度与自变量之间的关联。
在558名参与调查的医护人员中，277名（49.7%）是医生，281名（50.3%）是护士。纳入研究的医生和护士中近50%对艾滋病毒/艾滋病感染者有高度的污名化态度。在本研究纳入的不同卫生专业人员中，对艾滋病毒/艾滋病知识了解较少与对艾滋病毒/艾滋病感染者的污名化态度较高有关。在治疗艾滋病毒/艾滋病患者方面经验较多的医护人员中，包括工作中的歧视、对艾滋病的恐惧和偏见在内的污名化态度较低。
本研究首次报告了老挝人民民主共和国医护人员中与艾滋病毒/艾滋病相关的污名化情况。污名化态度导致预防、教育和治疗机会的错失，破坏了管理和预防艾滋病毒的努力。扭转污名化态度和行为需要针对污名化的情感、认知和行为方面的干预措施。与此同时，需要使卫生专业人员能够实施普遍预防措施并防止艾滋病毒职业传播。
