加利福尼亚州旧金山男男性行为者中的艾滋病毒污名的社会心理决定因素。

Psychosocial Determinants of HIV Stigma among Men Who Have Sex with Men in San Francisco, California.

机构信息

San Francisco AIDS Foundation, San Francisco, CA 94103, USA.

Division of Epidemiology and Biostatistics, University of California, Berkeley, CA 94720, USA.

出版信息

Int J Environ Res Public Health. 2021 Jul 29;18(15):8031. doi: 10.3390/ijerph18158031.

DOI:10.3390/ijerph18158031

PMID:34360326

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8345572/

Abstract

BACKGROUND

Stigma and discrimination are major challenges faced by people living with HIV (PLWH), and stigma continues to be prevalent among PLWH. We conducted a cross-sectional study of 584 men who have sex with men (MSM) living with HIV between July 2018 and December 2020, designed to better understand which demographic and behavioral characteristics of MSM living with HIV in San Francisco, California are associated with experience of stigma, so that programs and initiatives can be tailored appropriately to minimize HIV stigma's impacts.

METHODS

This analysis was conducted with data from San Francisco AIDS Foundation (SFAF) encompassing services from multiple different locations in San Francisco. Data about the level of HIV-related stigma experienced were collected through a single question incorporated into programmatic data collection forms at SFAF as part of the client record stored in SFAF's electronic health record. We performed linear regression to determine the associations between self-reported experiences of HIV stigma and other characteristics among MSM living with HIV.

RESULTS

HIV stigma was low overall among MSM living with HIV who are actively engaged in HIV care in San Francisco; however, it was significantly higher for the age groups of 13-29 years (adjusted risk difference (ARD): 0.251, 95% CI: 0.012, 0.489) and 30-49 years (ARD: 0.205, 95% CI: 0.042, 0.367) when compared to the age group of 50 years and older, as well as people who were homeless (ARD: 0.844, 95% CI: 0.120, 1.568), unstably housed (ARD: 0.326, 95% CI: 0.109, 0.543) and/or having mental health concerns (ARD: 0.309, 95% CI: 0.075, 0.544), controlling for race, injection history, and viral load.

CONCLUSIONS

These findings highlight an opportunity to develop culturally, socially, and racially appropriate interventions to reduce HIV stigma among MSM living with HIV, particularly for younger men and those struggling with housing stability and/or mental health.

摘要

背景

污名化和歧视是艾滋病毒感染者（PLWH）面临的主要挑战，而 PLWH 中仍然普遍存在污名化现象。我们对 2018 年 7 月至 2020 年 12 月期间加利福尼亚州旧金山的 584 名男男性行为者（MSM）进行了一项横断面研究，旨在更好地了解旧金山 HIV 感染者的人口统计学和行为特征与经历污名之间的关系，以便制定出相应的方案和举措，将 HIV 污名的影响降到最低。

方法

本分析采用了旧金山艾滋病基金会（SFAF）的数据，这些数据涵盖了旧金山多个不同地点的服务。通过在 SFAF 的项目数据收集表格中纳入的一个单一问题，收集了与 HIV 相关的污名经历程度的数据，作为 SFAF 电子健康记录中客户记录的一部分。我们进行了线性回归分析，以确定在旧金山积极参与 HIV 护理的 HIV 感染者中，自我报告的 HIV 污名经历与其他特征之间的关联。

结果

在旧金山积极参与 HIV 护理的 HIV 感染者中，HIV 污名总体较低；然而，与 50 岁及以上年龄组相比，13-29 岁（调整后的风险差异（ARD）：0.251，95%CI：0.012，0.489）和 30-49 岁（ARD：0.205，95%CI：0.042，0.367）年龄组以及无家可归者（ARD：0.844，95%CI：0.120，1.568）、住房不稳定者（ARD：0.326，95%CI：0.109，0.543）和/或有心理健康问题者（ARD：0.309，95%CI：0.075，0.544）的 HIV 污名程度显著更高，这是在控制种族、注射史和病毒载量的情况下得出的。