Saka Bayaki, Tchounga Boris, Ekouevi Didier K, Sehonou Céphas, Sewu Essèboè, Dokla Augustin, Maboudou Angèle, Kassankogno Yao, Palokinam Pitche Vincent
Sante Publique. 2017 Nov-Dec;29(6):897-907. doi: 10.3917/spub.176.0897.
Stigma and discrimination experienced by people living with HIV (PLWHA) prevent and delay access to prevention and treatment services. The aim of this study was to describe the patterns of stigma and discrimination experienced by PLWHA in Togo and to identify the associated factors.
A cross-sectional study was conducted in 2013 among PLWHA in Togo in order to collect data on stigma or discrimination experiences. Univariate and multivariate analyses were performed to identify associated factors.
A total of 891 PLWHA were interviewed, including 848 (95.2%) receiving antiretroviral therapy. External stigma (37.9%) was the major form of stigmatization followed by internalized stigma (35.4%). The main features of external stigma were gossip (36.5%) and issues to access education (36.0%). Internalized stigma mainly consisted of a feeling of guilt (37.6%) and self-devaluation (36.0%). In univariate and multivariate analysis, female gender was significantly associated with stigma (aOR = 1.73, 95% CI [1.08-2.77]). Of the 891 PLWHA, 75 (8.4%) reported a violation of their rights. Finally 27 (4.1%) were discouraged from having children by a health professional because of their HIV status.
Stigma affects more than one-third of PLWHA in Togo, more particularly females. It appears necessary to design new interventions and integrate psychosocial care in the management of PLWHA, in addition to antiretroviral therapy.
感染艾滋病毒者（PLWHA）所遭受的耻辱和歧视阻碍并延误了他们获得预防和治疗服务的机会。本研究的目的是描述多哥感染艾滋病毒者所遭受耻辱和歧视的模式，并确定相关因素。
2013年在多哥对感染艾滋病毒者开展了一项横断面研究，以收集有关耻辱或歧视经历的数据。进行单因素和多因素分析以确定相关因素。
共访谈了891名感染艾滋病毒者，其中848名（95.2%）正在接受抗逆转录病毒治疗。外部耻辱感（37.9%）是耻辱化的主要形式，其次是内化耻辱感（35.4%）。外部耻辱感的主要特征是流言蜚语（36.5%）和受教育问题（36.0%）。内化耻辱感主要包括内疚感（37.6%）和自我贬低（36.0%）。在单因素和多因素分析中，女性性别与耻辱感显著相关（调整后比值比 = 1.73，95%置信区间[1.08 - 2.77]）。在891名感染艾滋病毒者中，75名（8.4%）报告其权利受到侵犯。最后，27名（4.1%）因感染艾滋病毒而被卫生专业人员劝阻不要生育。
耻辱感影响了多哥三分之一以上的感染艾滋病毒者，女性受影响尤为严重。除抗逆转录病毒治疗外，似乎有必要设计新的干预措施，并将心理社会护理纳入感染艾滋病毒者的管理中。
