自主支持性医疗环境与艾滋病毒相关耻辱感预测西非加纳男男性行为者接受艾滋病毒治疗的关联
Autonomy-Supportive Healthcare Climate and HIV-Related Stigma Predict Linkage to HIV Care in Men Who Have Sex With Men in Ghana, West Africa.
作者信息
Gu Lily Y, Zhang Nanhua, Mayer Kenneth H, McMahon James M, Nam Soohyun, Conserve Donaldson F, Moskow Marian, Brasch Judith, Adu-Sarkodie Yaw, Agyarko-Poku Thomas, Boakye Francis, Nelson LaRon E
机构信息
School of Medicine, University of Utah, Salt Lake City, UT, USA.
Division of Biostatistics and Bioinformatics, Department of Environmental Health, 12348University of Cincinnati College of Medicine, Cincinnati, OH, USA.
出版信息
J Int Assoc Provid AIDS Care. 2021 Jan-Dec;20:2325958220978113. doi: 10.1177/2325958220978113.
Abstract
In Ghana, the HIV prevalence among MSM is more than 10 times greater than the general population of adults, and rates of engagement in HIV medical care are low among MSM diagnosed with HIV. Using structured surveys, we investigated the impact of HIV-related stigma, same-sex behavior stigma, and gender nonconformity stigma on linkage to HIV care (LTC) in MSM ( = 225) living with HIV in Ghana. Autonomy-supportive healthcare climate ( = 1.63, < .01), vicarious HIV stigma ( = 2.73, < .01), and age ( = 1.06, p < .004) predicted LTC. Conversely, felt normative HIV stigma negatively predicted LTC ( = 0.65, < .05). Finally, we identified regional disparities, with MSM from Takoradi being 4 times and 5 times more likely to be LTC compared to Kumasi and Accra, respectively. Our findings highlight the nuanced roles of stigmas in shaping the HIV care continuum among MSM living with HIV, while revealing potential gaps in current measures of HIV-related stigma.
摘要
在加纳，男男性行为者中的艾滋病毒流行率比成年总人口高出10倍以上，而且被诊断感染艾滋病毒的男男性行为者接受艾滋病毒医疗护理的比例较低。我们通过结构化调查，研究了艾滋病毒相关耻辱感、同性行为耻辱感和性别非一致性耻辱感对加纳225名感染艾滋病毒的男男性行为者与艾滋病毒护理服务建立联系（LTC）的影响。自主性支持性医疗氛围（β = 1.63，p <.01）、替代性艾滋病毒耻辱感（β = 2.73，p <.01）和年龄（β = 1.06，p <.004）可预测与艾滋病毒护理服务建立联系的情况。相反，感受到的规范性艾滋病毒耻辱感对与艾滋病毒护理服务建立联系的情况具有负向预测作用（β = 0.65，p <.05）。最后，我们发现了地区差异，与库马西和阿克拉相比，来自塔科拉迪的男男性行为者与艾滋病毒护理服务建立联系的可能性分别高出4倍和5倍。我们的研究结果突出了耻辱感在塑造感染艾滋病毒的男男性行为者的艾滋病毒护理连续过程中的细微作用，同时揭示了当前艾滋病毒相关耻辱感衡量指标中可能存在的差距。
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