Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD.
Programme d'Appui au Monde Associatif et Communautaire, Ouagadougou, Burkina Faso.
Ann Epidemiol. 2018 Jan;28(1):13-19. doi: 10.1016/j.annepidem.2017.11.009. Epub 2017 Dec 5.
The aim of this study is to examine the prevalence and correlates of perceived health care stigma among female sex workers (FSWs) and men who have sex with men (MSM), including other stigma types, suicidal ideation, and participation in social activities.
FSWs (N = 350) and MSM (N = 330) aged ≥18 were recruited in Bobo-Dioulasso, Burkina Faso. Perceived health care stigma was defined as either ever being afraid of or avoiding health care services because someone might find out the participant has sex with men (for MSM) or sells sex (for FSW). Correlates of perceived health care stigma were examined using multivariable logistic regression.
The prevalence of perceived health care stigma was 14.9% (52/350) and 24.5% (81/330) in FSWs and MSM, respectively. Among FSWs, experienced or social stigma, including verbal harassment (adjusted odds ratio [aOR] = 3.59, 95% confidence interval [CI] 1.48-8.71), feeling rejected by friends (aOR = 2.30, 95% CI 1.14-4.64), and feeling police refused to protect them (aOR = 2.58, 95% CI 1.27-5.25), was associated with perceived health care stigma. Among MSM, experiencing verbal harassment (aOR = 1.95, 95% CI 1.09-3.50) and feeling scared to walk in public (aOR = 2.93, 95% CI 1.47-5.86) were associated with perceived health care stigma.
In these key populations, perceived health care stigma was prevalent and associated with experienced and social stigmas. To increase coverage of effective HIV services, interventions should incorporate approaches to comprehensively mitigate stigma.
本研究旨在调查女性性工作者（FSW）和男男性行为者（MSM）中感知的医疗保健污名的流行情况和相关因素，包括其他污名类型、自杀意念和参与社会活动。
在布基纳法索博博-迪乌拉索招募了 350 名 FSW 和 330 名 MSM，年龄均≥18 岁。感知的医疗保健污名定义为因为某人可能发现参与者与男性发生性关系（对 MSM 而言）或卖淫（对 FSW 而言）而曾经害怕或避免医疗保健服务。使用多变量逻辑回归分析感知的医疗保健污名的相关因素。
FSW 和 MSM 中感知的医疗保健污名的流行率分别为 14.9%（52/350）和 24.5%（81/330）。在 FSW 中，经历过或社会污名，包括言语骚扰（调整后的优势比[aOR] = 3.59，95%置信区间[CI] 1.48-8.71）、被朋友拒绝（aOR = 2.30，95% CI 1.14-4.64）和感觉警察拒绝保护他们（aOR = 2.58，95% CI 1.27-5.25）与感知的医疗保健污名相关。在 MSM 中，经历言语骚扰（aOR = 1.95，95% CI 1.09-3.50）和害怕在公共场所行走（aOR = 2.93，95% CI 1.47-5.86）与感知的医疗保健污名相关。
在这些关键人群中，感知的医疗保健污名很普遍，与经历过的和社会污名有关。为了增加有效 HIV 服务的覆盖范围，干预措施应采取综合措施来减轻污名。
