Mao Yuchen, Li Xiaoming, Qiao Shan, Zhao Qun, Zhou Yuejiao, Shen Zhiyong
a Department of Health Promotion, Education, and Behavior , University of South Carolina , Columbia , SC , USA.
b School of Public Administration , Nanjing University of Information Science & Technology , Nanjing , People's Republic of China.
AIDS Care. 2018 Feb;30(2):168-172. doi: 10.1080/09540121.2017.1387639. Epub 2017 Oct 11.
Both stigma and social support have been identified to be associated with HIV status disclosure among people living with HIV. This study aimed to examine cross-sectional associations of perceived social support and multiple types of stigma with both disclosure to various target groups and timing of disclosure among parents living with HIV (PLHIV) in Guangxi, China. Cross-sectional data from 1254 PLHIV in Guangxi, China were analyzed. Measures included demographics, disclosure to specific groups (steady partner/spouse, children, family and others) and timing of disclosure, perceived social support, and three types of HIV-related stigma (perceived, internalized, and enacted stigma). Logistic regression analyses were performed to identify the associations of interest. The participants who reported higher levels of perceived social support were more likely to have disclosed to steady partner/spouse, family or others. Those who experienced enacted stigma were more likely to have disclosed to children or family. Those who were married/cohabitating were more likely to have disclosed to steady partner/spouse, and less likely to have disclosed to children, family or others. Older PLHIV were less likely to have disclosed to steady partner/spouse, or family. Those who had a job were more likely to have disclosed to steady partner/spouse. Perceived social support appeared not to be associated with timing of disclosure. Those who disclosed within a shorter time after diagnosis were more likely to be women or have disclosed to steady partner/spouse, and less likely to have higher perceived stigma or have disclosed to family. Interventions are needed to help reduce the negative effect of perceived stigma at both family and community levels and to help enhance perceived social support in general and emotional support in particular among PLHIV, especially males and older adults.
耻辱感和社会支持都被认为与艾滋病毒感染者披露其感染状况有关。本研究旨在探讨社会支持感和多种耻辱感类型与中国广西艾滋病毒感染父母(PLHIV)向不同目标群体披露感染状况及披露时间的横断面关联。对来自中国广西1254名艾滋病毒感染父母的横断面数据进行了分析。测量指标包括人口统计学特征、向特定群体(固定伴侣/配偶、子女、家人及其他人)的披露情况和披露时间、社会支持感以及三种与艾滋病毒相关的耻辱感(感知到的耻辱感、内化的耻辱感和表现出的耻辱感)。进行了逻辑回归分析以确定感兴趣的关联。报告社会支持感水平较高的参与者更有可能向固定伴侣/配偶、家人或其他人披露感染状况。经历过表现出的耻辱感的人更有可能向子女或家人披露感染状况。已婚/同居的人更有可能向固定伴侣/配偶披露感染状况,而向子女、家人或其他人披露的可能性较小。年龄较大的艾滋病毒感染父母向固定伴侣/配偶或家人披露感染状况的可能性较小。有工作的人更有可能向固定伴侣/配偶披露感染状况。社会支持感似乎与披露时间无关。诊断后较短时间内披露感染状况的人更有可能是女性或已向固定伴侣/配偶披露,并且更不容易有较高的感知耻辱感或向家人披露。需要开展干预措施,以帮助减少家庭和社区层面感知到的耻辱感的负面影响,并帮助增强艾滋病毒感染父母总体上的社会支持感,特别是情感支持,尤其是男性和老年人。