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加纳三个直辖市的艾滋病毒污名和状况披露。

HIV Stigma and Status Disclosure in Three Municipalities in Ghana.

机构信息

Department of Family and Community Health, School of Public Health, University of Health and Allied Sciences, Ho, Ghana.

Center for Health Literacy and Rural Health Promotion, P. O. Box GP1563, Accra, Ghana.

出版信息

Ann Glob Health. 2021 Jun 18;87(1):49. doi: 10.5334/aogh.3120.

Abstract

BACKGROUND

HIV-related stigma and HIV status disclosure are important elements in the continuous fight against HIV as these impact the prevention efforts and antiretroviral treatment adherence among people living with HIV/AIDS (PLWHA) in many communities.

OBJECTIVES

The objectives of the study were to examine the prevalence and experience of various types of HIV-related stigma and HIV status disclosure among PLWHA in Volta region.

METHODS

A cross-sectional design was used to collect quantitative data from 301 PLWHA. Descriptive statistics were used to analyze and present data on socio-demographic variables. Correlation analysis was done to determine factors associated with HIV stigma and status disclosure while a Mann-Whitney U test was used to determine differences in internalized HIV stigma.

FINDINGS

The mean age of the participants was 44.82 (SD: 12.22), 224 (74.4%) were female, and 90% attained at least primary education. A Pearson analysis revealed that ethnicity (r[299] = 0.170, p = 0.003), religious affiliation (r[299] = -0.205, p = 0.001) and social support (r[299] = 0.142, p = 0.014) significantly predicted disclosure of HIV status. Fear of family rejection (62%) and shame (56%) were reasons for non-disclosure of HIV status. A Mann-Whitney's revealed that females are more likely than males to internalize HIV stigma. Community-related HIV stigma in the form of gossip (56.1%), verbal harassment (30.9%), and physical harassment (8.6%) was reported.

CONCLUSION

A high rate of HIV status disclosure was found with social support, ethnicity, and religious affiliation being the associated factors. Internalized HIV stigma is prevalent among PLWHA while community-related stigma impacts HIV status disclosure. Strengthening social support systems and implementing culturally appropriate educational interventions may help in reducing community-related HIV stigma.

摘要

背景

艾滋病毒相关耻辱感和艾滋病毒状况披露是与艾滋病毒作斗争的重要内容,因为这些因素会影响许多社区艾滋病毒感染者/艾滋病患者(PLWHA)的预防工作和抗逆转录病毒治疗的坚持情况。

目的

本研究的目的是检查沃尔塔地区 PLWHA 中各种类型的艾滋病毒相关耻辱感和艾滋病毒状况披露的流行情况和经验。

方法

采用横断面设计,从 301 名 PLWHA 中收集定量数据。使用描述性统计分析来分析和呈现社会人口统计学变量的数据。相关性分析用于确定与艾滋病毒耻辱感和状况披露相关的因素,而曼-惠特尼 U 检验用于确定内化艾滋病毒耻辱感的差异。

结果

参与者的平均年龄为 44.82(SD:12.22),224 人(74.4%)为女性,90%至少接受过小学教育。皮尔逊分析显示,族裔(r[299]=0.170,p=0.003)、宗教信仰(r[299]=-0.205,p=0.001)和社会支持(r[299]=0.142,p=0.014)显著预测了艾滋病毒状况的披露。害怕家庭拒绝(62%)和羞耻感(56%)是不披露艾滋病毒状况的原因。曼-惠特尼检验显示,女性比男性更有可能内化艾滋病毒耻辱感。报告了以八卦(56.1%)、言语骚扰(30.9%)和身体骚扰(8.6%)形式出现的社区相关艾滋病毒耻辱感。

结论

发现艾滋病毒状况披露率较高,社会支持、族裔和宗教信仰是相关因素。PLWHA 中普遍存在内化的艾滋病毒耻辱感,而社区相关耻辱感会影响艾滋病毒状况的披露。加强社会支持系统和实施文化上适当的教育干预措施,可能有助于减少社区相关的艾滋病毒耻辱感。

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