Han B F, Yuan Q L, Liu J, Liu Y Q, Huang N H, Cui F Q
School of Public Health, Peking University, Beijing 100191, China.
Beijing Center for Disease Control and Prevention, Beijing 100013, China.
Zhonghua Liu Xing Bing Xue Za Zhi. 2020 Apr 10;41(4):504-507. doi: 10.3760/cma.j.cn112338-20190603-00389.
This study intended to explore the current sexual and childbearing stigma, experienced by chronic hepatitis B patients in China, and to develop related preventive strategies. We used a self-made questionnaire to investigate the sexual and childbearing stigma suffered by chronic hepatitis B patients in four provinces of China. Analysis of variance and chi-square test were used to compare the differences on sexual and childbearing stigma indexes between different demographic variables. We surveyed 797 chronic hepatitis B patients in four provinces. Among them, 4.15 (28/675) of the patients were persuaded not to give birth to children, and 4.67 (10/210) of patients were told to stop pregnancy, by their medical care takers or by members from the family planning institutions. 3.62 (25/690) and 3.48 (24/690) of the patients were not able to enjoy the family planning or reproductive health services as they were stigmatized,suffered, as having HBV infection. Among the male chronic hepatitis B patients, the under 30 years group suffered less sexual and childbearing stigma than those who were aged 31- (=0.011) or 51 and above year-olds (=0.009). Among female chronic hepatitis B patients, the 31- year-olds group suffered less sexual and childbearing stigma than those under 30 years group but higher than those aged 41- (=0.001) or 51 and above ones (<0.001). Patients with knowledge on route of sexual transmission for HBV, were more likely to practice less related sexual behaviors than those without such knowledge (=0.022). Patients who were aware or not that condoms could reduce the risk of HBV infection did not show statistically significant difference on sex behaviors (=0.612). Chronic hepatitis B patients did suffer from sexual and childbearing related stigma, with women aged 31-40 years old the most. It is necessary to advocate on the advantage of condom use for prevention of HBV transmission among pregnant women, both horizontally and vertically. Strategies on protection the rights of patients with hepatitis B should be developed and strengthened.
本研究旨在探讨中国慢性乙型肝炎患者当前所经历的性与生育方面的耻辱感,并制定相关预防策略。我们使用自制问卷对中国四个省份的慢性乙型肝炎患者所遭受的性与生育方面的耻辱感进行调查。采用方差分析和卡方检验比较不同人口学变量在性与生育耻辱感指标上的差异。我们对四个省份的797名慢性乙型肝炎患者进行了调查。其中,4.15%(28/675)的患者被医护人员或计划生育机构成员劝说不要生育,4.67%(10/210)的患者被告知终止妊娠。3.62%(25/690)和3.48%(24/690)的患者因被污名化为感染乙肝病毒而无法享受计划生育或生殖健康服务。在男性慢性乙型肝炎患者中,30岁以下组所遭受的性与生育耻辱感低于31岁及以上(=0.011)或51岁及以上组(=0.009)。在女性慢性乙型肝炎患者中,31岁组所遭受的性与生育耻辱感低于30岁以下组,但高于41岁及以上组(=0.001)或51岁及以上组(<0.001)。了解乙肝病毒性传播途径的患者比不了解的患者更有可能减少相关性行为(=0.022)。知晓或不知晓避孕套可降低乙肝病毒感染风险的患者在性行为方面无统计学显著差异(=0.612)。慢性乙型肝炎患者确实遭受性与生育相关的耻辱感,其中31至40岁的女性最为严重。有必要宣传使用避孕套预防孕妇水平和垂直传播乙肝病毒的益处。应制定并加强保护乙肝患者权利的策略。