定量分析和与抗逆转录病毒疗法治疗下的艾滋病毒/艾滋病患者相关的艾滋病毒耻辱感的因素：喀麦隆西北大区班姆enda 地区医院艾滋病毒日托中心的研究。
Quantification and factors associated with HIV-related stigma among persons living with HIV/AIDS on antiretroviral therapy at the HIV-day care unit of the Bamenda Regional Hospital, North West Region of Cameroon.
机构信息
Kekem District Hospital, Kekem town, West Region, Cameroon.
Department of Obstetrics and Gynaecology, Faculty of Medicine and Biomedical Sciences, University of Yaoundé I, Yaoundé, Cameroon.
出版信息
Global Health. 2018 Jun 5;14(1):56. doi: 10.1186/s12992-018-0374-5.
BACKGROUND
The Human Immunodeficiency Virus /Acquired Immune Deficiency Syndrome (HIV/AIDS) is not just a medical problem but its social impact is increasingly affecting its effective management. The fear of HIV-stigma constitutes a major barrier to HIV testing, prevention, uptake and adherence to antiretroviral therapy (ART). We aimed to quantify HIV-related stigma, and identify the factors associated with high HIV-related stigma among persons living with HIV and AIDS (PLHIVA) and on ART.
METHODS
A hospital-based cross sectional analytic survey targeting PLHIVA on ART at the HIV-day care unit of the Bamenda Regional Hospital of Cameroon was conducted from February to April 2016. A total of 308 eligible and willing participants were consecutively included in the survey. Data were collected using a pretested questionnaire designed from the Berger HIV stigma scale and analyzed using Epi info 3.5.4.
RESULTS
The mean age of the 308 participants was 40.1±10.2 years. The mean overall HIV/AIDS related stigma score was 88.3 ± 18.80 which corresponds to a moderate level of stigma according to the Berger stigma scale. Further analysis revealed that most participants suffered from moderate forms of the different subtypes of stigma including: personalized (49.8%), disclosure (66.4%), negative self-image (50.0%) and public attitude (52.1%) stigmatization. It was estimated that 62.7% (95% confidence interval [CI] = 57.8-68.9%) of the participants lived with high levels of HIV-related stigma. After controlling for gender, religion, age and occupation, level of education below tertiary (Adjusted Odds Ratio [AOR] = 0.70 [95% CI = 0.44-0.91]; p = 0.036) and a duration from diagnosis below 5 years (AOR = 1.74 [95% CI = 1.01-3.00]; p = 0.046) were significantly associated with high HIV-related stigma.
CONCLUSION
About three out of every five PLHIVA receiving ART in Bamenda Regional Hospital still experience high levels of HIV-related stigma. This occurs more frequently in participants with low educational status, and who may have known their HIV status for less than 5 years. Anti-HIV-stigma programs in the North West Region need strengthening with intensified psychosocial follow-up of newly diagnosed cases.
背景
人类免疫缺陷病毒/获得性免疫缺陷综合征（HIV/AIDS）不仅是一个医学问题，其带来的社会影响也日益影响着对其的有效管理。对 HIV 污名的恐惧是 HIV 检测、预防、接受和坚持抗逆转录病毒治疗（ART）的主要障碍。我们旨在量化 HIV 相关耻辱感，并确定与接受抗逆转录病毒治疗（ART）的 HIV 感染者和艾滋病患者（PLHIVA）以及接受 ART 的患者中与 HIV 相关的高度耻辱感相关的因素。
方法
2016 年 2 月至 4 月，在喀麦隆巴门达地区医院的 HIV 日间护理中心，对接受 ART 的 PLHIVA 进行了一项基于医院的横断面分析调查。共有 308 名符合条件且愿意参加的参与者连续参加了这项调查。使用从 Berger HIV 耻辱量表设计的预测试问卷收集数据，并使用 Epi info 3.5.4 进行分析。
结果
308 名参与者的平均年龄为 40.1±10.2 岁。平均整体 HIV/AIDS 相关耻辱感评分为 88.3±18.80，根据 Berger 耻辱量表，这属于中度耻辱感。进一步分析显示，大多数参与者遭受着不同亚型的中度耻辱感，包括：个人化（49.8%）、披露（66.4%）、自我形象负面（50.0%）和公众态度（52.1%）的耻辱感。据估计，62.7%（95%置信区间 [CI] = 57.8-68.9%）的参与者生活在高度与 HIV 相关的耻辱感中。在控制性别、宗教、年龄和职业后，低于大专教育水平（调整后的优势比 [AOR] = 0.70 [95%CI = 0.44-0.91]；p = 0.036）和诊断后不到 5 年（AOR = 1.74 [95%CI = 1.01-3.00]；p = 0.046）与高度与 HIV 相关的耻辱感显著相关。
结论
在巴门达地区医院接受 ART 的 PLHIVA 中，约有五分之三的人仍经历着高度的与 HIV 相关的耻辱感。在教育程度较低的参与者中，这种情况更为常见，而且他们可能在不到 5 年前就知道自己的 HIV 状况。西北区需要加强抗 HIV 耻辱感项目，并加强对新诊断病例的心理社会随访。
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