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本文引用的文献

1
HIV-Related Stigma and Overlapping Stigmas Towards People Living With HIV Among Health Care Trainees in Canada.加拿大医疗保健实习生中与艾滋病毒相关的耻辱感以及对艾滋病毒感染者的重叠耻辱感。
AIDS Educ Prev. 2017 Aug;29(4):364-376. doi: 10.1521/aeap.2017.29.4.364.
2
Stigma related to HIV and AIDS as a barrier to accessing health care in Thailand: a review of recent literature.泰国与艾滋病毒和艾滋病相关的污名化成为获取医疗保健的障碍:近期文献综述
WHO South East Asia J Public Health. 2013 Jan-Mar;2(1):12-22. doi: 10.4103/2224-3151.115829.
3
The role of people living with HIV as patient instructors - reducing stigma and improving interest around HIV care among medical students.艾滋病毒感染者作为患者指导者的作用——减少耻辱感并提高医学生对艾滋病毒护理的关注度。
AIDS Care. 2017 Apr;29(4):524-531. doi: 10.1080/09540121.2016.1224314. Epub 2016 Aug 31.
4
Examining the associations between HIV-related stigma and health outcomes in people living with HIV/AIDS: a series of meta-analyses.探究艾滋病毒/艾滋病感染者中与艾滋病毒相关的耻辱感和健康结果之间的关联:一系列荟萃分析。
BMJ Open. 2016 Jul 13;6(7):e011453. doi: 10.1136/bmjopen-2016-011453.
5
"I just think that doctors need to ask more questions": Sexual minority and majority adolescents' experiences talking about sexuality with healthcare providers.“我只是觉得医生需要多问些问题”:性少数群体和性多数群体青少年与医疗服务提供者谈论性取向的经历
Patient Educ Couns. 2016 Sep;99(9):1467-72. doi: 10.1016/j.pec.2016.06.004. Epub 2016 Jun 14.
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Predictors of the Sexual Well-being of Individuals Diagnosed with Herpes and Human Papillomavirus.被诊断患有疱疹和人乳头瘤病毒的个体性健康状况的预测因素。
Arch Sex Behav. 2016 Feb;45(2):403-14. doi: 10.1007/s10508-014-0388-x. Epub 2014 Nov 19.
7
Health care provider attitudes and beliefs about people living with HIV: Initial validation of the Health Care Provider HIV/AIDS Stigma Scale (HPASS).医疗服务提供者对艾滋病毒感染者的态度和信念:医疗服务提供者艾滋病毒/艾滋病污名量表(HPASS)的初步验证。
AIDS Behav. 2014 Dec;18(12):2397-408. doi: 10.1007/s10461-014-0834-8.
8
Gender and ethnicity differences in HIV-related stigma experienced by people living with HIV in Ontario, Canada.加拿大安大略省 HIV 感染者所经历的 HIV 相关污名的性别和种族差异。
PLoS One. 2012;7(12):e48168. doi: 10.1371/journal.pone.0048168. Epub 2012 Dec 27.
9
HIV testing experiences of Aboriginal youth in Canada: service implications.加拿大原住民青年的艾滋病毒检测经历:对服务的启示
AIDS Care. 2010 Oct;22(10):1269-76. doi: 10.1080/09540121003692201.
10
The role of physician and nurse attitudes in the health care of injecting drug users.医生和护士态度在注射吸毒者医疗保健中的作用。
Subst Use Misuse. 2010 Jun;45(7-8):1007-18. doi: 10.3109/10826081003659543.

用于应对与性取向、物质使用以及性传播和血源感染相关的污名化问题的资源。

Resources to address stigma related to sexuality, substance use and sexually transmitted and blood-borne infections.

作者信息

MacLean R

机构信息

Canadian Public Health Association, Ottawa, ON.

出版信息

Can Commun Dis Rep. 2018 Feb 1;44(2):62-67. doi: 10.14745/ccdr.v44i02a05.

DOI:10.14745/ccdr.v44i02a05
PMID:29770101
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC5864309/
Abstract

BACKGROUND

Stigma is widely recognized as a significant barrier to the prevention, management and treatment of sexually transmitted and blood-borne infections (STBBIs) in Canada. Despite major advances in STBBI prevention and treatment, and global efforts to reduce stigma, people living with or affected by STBBIs continue to experience stigma within health and social service settings in Canada.

OBJECTIVE

To describe the development, content and evaluation of knowledge translation resources and training workshops designed to equip health and social service professionals with the knowledge and skills needed to provide more respectful and inclusive sexual health, harm reduction and STBBI services.

METHODS

After conducting a literature review, environmental scan and key informant interviews, and developing a conceptual framework, the Canadian Public Health Association (CPHA) developed four knowledge translation resources and three training workshops in partnership with a number of community-based organizations and experts. The resources were drafted and reviewed by both service providers and individuals affected by STBBIs. The workshops were developed, piloted and then evaluated using post-workshop questionnaires.

RESULTS

The four resources developed were a self-assessment tool related to STBBIs and stigma; a service provider discussion guide to facilitate respectful and inclusive discussions on issues related to sexuality, substance use and STBBIs; a toolkit focused on stigma reduction, privacy, confidentiality and the criminalization of HIV non-disclosure; and an organizational assessment tool related to STBBIs and stigma for health and social service settings. These knowledge translation resources were subsequently integrated into the content of three face-to-face trainings that were piloted and evaluated across the country. Post-workshop evaluation had an overall 85% response rate; 88% of participants noted increased awareness of various forms of stigma, 87% noted increased comfort discussing sexuality, substance use and harm reduction with their clients/patients, 90% reported increased awareness of organizational strategies to reduce stigma, and 93% reported being able to integrate workshop learnings into practice. In addition, there was strong support for professional development on issues related to STBBI stigma reduction.

CONCLUSION

These knowledge translation resources and training workshops represent a comprehensive set of tools developed in Canada that service providers can use to help reduce stigma when caring for clients/patients with STBBIs and related conditions. Evaluation indicates there is a strong willingness among health and social service providers to engage in educational opportunities in this area and that participation in the training workshops led to increased awareness and a willingness to adopt best practices.

摘要

背景

在加拿大,耻辱感被广泛认为是性传播和血源感染(STBBIs)预防、管理及治疗的重大障碍。尽管STBBIs的预防和治疗取得了重大进展,且全球都在努力减少耻辱感,但感染STBBIs或受其影响的人在加拿大的健康和社会服务环境中仍面临耻辱。

目的

描述知识转化资源及培训工作坊的开发、内容和评估情况,这些资源和工作坊旨在让健康和社会服务专业人员具备提供更具尊重性和包容性的性健康、减少伤害及STBBIs服务所需的知识和技能。

方法

在进行文献综述、环境扫描和关键信息访谈并制定概念框架后,加拿大公共卫生协会(CPHA)与一些社区组织和专家合作,开发了四种知识转化资源和三个培训工作坊。这些资源由服务提供者和受STBBIs影响的个人起草和审核。工作坊经过开发、试点,然后使用工作坊后的问卷进行评估。

结果

开发的四种资源分别是:与STBBIs和耻辱感相关的自我评估工具;促进就性、物质使用和STBBIs相关问题进行尊重性和包容性讨论的服务提供者讨论指南;侧重于减少耻辱感、隐私、保密以及将不披露艾滋病毒定为刑事犯罪的工具包;以及针对健康和社会服务环境中与STBBIs和耻辱感相关的组织评估工具。这些知识转化资源随后被纳入在全国进行试点和评估的三次面对面培训的内容中。工作坊后的评估总体回复率为85%;88%的参与者表示对各种形式的耻辱感的认识有所提高,87%的参与者表示在与客户/患者讨论性、物质使用和减少伤害方面更自在了,90%的参与者报告对减少耻辱感的组织策略的认识有所提高,93%的参与者报告能够将工作坊所学融入实践。此外,对于与减少STBBIs耻辱感相关问题的专业发展有强烈支持。

结论

这些知识转化资源和培训工作坊是加拿大开发的一套全面工具,服务提供者可用于在照顾感染STBBIs及相关病症的客户/患者时帮助减少耻辱感。评估表明,健康和社会服务提供者非常愿意参与该领域的教育机会,且参与培训工作坊提高了认识并愿意采用最佳实践。