Yin Yao, Yang Hui, Xie Xia, Wang Huan, Nie Anliu, Chen Hong
West China School of Nursing and Department of Nursing, West China Hospital, Sichuan University, Chengdu, Sichuan, China.
Medicine (Baltimore). 2019 Aug;98(31):e16681. doi: 10.1097/MD.0000000000016681.
Human immunodeficiency virus (HIV) disclosure is a prerequisite to get access to antiretroviral therapy (ART) and social support. Increased disclosure of HIV status has been shown to reduce mother-to-child transmission and high-risk sexual behaviors. Limited studies were conducted to get an insight into HIV disclosure among people living with HIV/acquired immune deficiency syndrome (AIDS) (PLWHA) in Liangshan.Our study aimed to investigate the status and associated characteristics of HIV disclosure among PLWHA in Liangshan.We conducted a cross-sectional study using a stratified, convenience sampling method from August to December in 2017. All of the participants were from Liangshan, a typical impoverished mountainous area which also has a long history of drug production and drug trade. Each participant completed a structured questionnaire including HIV disclosure status, demographic and HIV-related characteristics, social support, and perceived HIV-related stigma. We performed a binary regression analysis to detect associated characteristics of HIV disclosure among PLWHA in Liangshan.A final sample size of 318 participants was included in this study. The overall prevalence of HIV disclosure was 83.6% (266/318). In binary logistic regression analysis, PLWHA who had higher educational levels, and got infected by sexual transmission were less likely to disclose their HIV status (both P < .05). HIV nondisclosure was correlated with a higher level of perceived HIV-related stigma (P < .01).The prevalence of HIV disclosure was relatively low in Liangshan. Healthcare workers are suggested to conduct more counseling and education to promote safe sexual behaviors and reduce perceived stigma among PLWHA, then enhance HIV serostatus disclosure.
披露人类免疫缺陷病毒（HIV）感染状况是获得抗逆转录病毒疗法（ART）和社会支持的前提条件。研究表明，增加HIV感染状况的披露可减少母婴传播和高危性行为。针对凉山地区人类免疫缺陷病毒/获得性免疫缺陷综合征（HIV/AIDS）患者（PLWHA）的HIV感染状况披露情况，开展的研究较少。我们的研究旨在调查凉山地区PLWHA的HIV感染状况披露情况及其相关特征。2017年8月至12月，我们采用分层便利抽样方法进行了一项横断面研究。所有参与者均来自凉山，这是一个典型的贫困山区，同时也是毒品生产和毒品交易历史悠久的地区。每位参与者均完成了一份结构化问卷，内容包括HIV感染状况披露情况、人口统计学和HIV相关特征、社会支持以及感知到的HIV相关耻辱感。我们进行了二元回归分析，以检测凉山地区PLWHA的HIV感染状况披露的相关特征。本研究最终纳入了318名参与者。HIV感染状况披露的总体患病率为83.6%（266/318）。在二元逻辑回归分析中，教育水平较高且通过性传播感染HIV的PLWHA披露其HIV感染状况的可能性较小（均P<0.05）。未披露HIV感染状况与较高水平的HIV相关耻辱感相关（P<0.01）。凉山地区HIV感染状况披露的患病率相对较低。建议医护人员开展更多咨询和教育，以促进安全性行为，减少PLWHA的耻辱感，进而提高HIV血清学状态的披露率。
