越南社区卫生工作者中与艾滋病毒和药物使用相关的耻辱感及服务提供情况
HIV- and Drug Use-Related Stigma and Service Provision Among Community Health Workers in Vietnam.
作者信息
Li Li, Lin Chunqing, Liang Li-Jung, Chen Jun, Feng Nan, Nguyen Anh Tuan
机构信息
Semel Institute for Neuroscience and Human Behavior, Center for Community Health, University of California, Los Angeles, California.
National Institute of Hygiene and Epidemiology, Hanoi, Vietnam.
出版信息
AIDS Educ Prev. 2020 Apr;32(2):169-179. doi: 10.1521/aeap.2020.32.2.169.
This study compared community health workers' (CHW) stigma towards people living with HIV (PLH) and people who use drugs (PWUD) and explored the relationship between stigma and CHWs' confidence level in providing HIV/drug-related services. Using two sets of identically worded questions, levels of stigma towards PWUD and PLH were measured among 120 CHW from 60 communes in Vietnam. The associations between CHWs' confidence in service provision and stigma towards PWUD and PLH were examined using a linear mixed-effects regression model. The majority of the CHW reported higher levels of stigma towards PWUD than towards PLH. Compared to the CHW reporting higher stigma towards PWUD, those with higher stigma towards PLH were significantly less confident in service provision. Social opprobrium attached to drug-using behaviors can be a major driver behind the overall HIV stigma. CHWs' fear of HIV infection should be tackled to boost their confidence in HIV/drug-related care provision.
本研究比较了社区卫生工作者（CHW）对艾滋病毒感染者（PLH）和吸毒者（PWUD）的污名化情况，并探讨了污名与社区卫生工作者提供艾滋病毒/毒品相关服务的信心水平之间的关系。使用两组措辞相同的问题，对越南60个公社的120名社区卫生工作者对吸毒者和艾滋病毒感染者的污名化程度进行了测量。使用线性混合效应回归模型检验了社区卫生工作者在服务提供方面的信心与对吸毒者和艾滋病毒感染者的污名化之间的关联。大多数社区卫生工作者报告称，对吸毒者的污名化程度高于对艾滋病毒感染者的污名化程度。与对吸毒者污名化程度较高的社区卫生工作者相比，对艾滋病毒感染者污名化程度较高的社区卫生工作者在服务提供方面的信心明显较低。与吸毒行为相关的社会耻辱感可能是整体艾滋病毒污名化背后的主要驱动因素。应解决社区卫生工作者对艾滋病毒感染的恐惧，以增强他们在提供艾滋病毒/毒品相关护理方面的信心。
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