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HIV/AIDS 污名与 HIV/AIDS 四十年来的心理健康:系统回顾和荟萃分析。

HIV/AIDS stigma and psychological well-being after 40 years of HIV/AIDS: a systematic review and meta-analysis.

机构信息

Faculty of Psychology, University of Warsaw, Warsaw, Poland.

Faculty of Psychology, SWPS University of Social Sciences and Humanities, Warsaw, Poland.

出版信息

Eur J Psychotraumatol. 2021 Nov 25;12(1):1990527. doi: 10.1080/20008198.2021.1990527. eCollection 2021.

Abstract

BACKGROUND

In June 2021, 40 years have passed since the first cases of HIV infection were detected. Nonetheless, people living with HIV (PLWH) still suffer from intense HIV-related distress and trauma, which is nowadays mostly linked to the still-existing stigmatization of PLWH.

OBJECTIVES

The aim of this systematic review and meta-analysis was to examine the association between HIV/AIDS stigma and psychological well-being among PLWH. We also explored whether this association varies as a function of sociodemographic and clinical characteristics as well as study publication year and stigma measurement.

METHOD

A structured literature search was performed on Web of Science, Scopus, PsyARTICLES, MedLine, ProQuest, and Google Scholar databases. The inclusion criteria were quantitative, peer-reviewed articles published in English between 1996 and 2020.

RESULTS

After selection, 64 articles were accepted for further analysis ( = 25,294 participants). The random-effects pooled estimate revealed an overall negative and medium-strength association between stigma and well-being (r = -.31, 95% CI [-.35; -.26]). The participants' age modified this effect with a stronger association for older PLWH. Other sociodemographic and clinical variables as well as publication year and stigma measurement did not explain the variation in association between stigma and well-being across studies.

CONCLUSIONS

The present meta-analysis and systematic review not only showed an expected negative relationship between stigma and well-being but also revealed a substantial heterogeneity between studies that suggests a strong role of context of a given study. This finding calls for more advanced theoretical and analytical models to identify protective and vulnerability factors to effectively address them in clinical practice and interventions.

摘要

背景

2021 年 6 月,首例艾滋病病毒感染病例被发现已经过去了 40 年。尽管如此,艾滋病毒感染者(PLWH)仍然深受与艾滋病相关的痛苦和创伤的困扰,而这些问题如今主要与 PLWH 仍然存在的污名化有关。

目的

本系统评价和荟萃分析旨在研究艾滋病病毒/艾滋病污名与 PLWH 心理健康之间的关联。我们还探讨了这种关联是否因社会人口学和临床特征以及研究发表年份和污名测量而有所不同。

方法

在 Web of Science、Scopus、PsyARTICLES、MedLine、ProQuest 和 Google Scholar 数据库中进行了结构化文献检索。纳入标准是 1996 年至 2020 年间以英文发表的定量、同行评议的文章。

结果

经过筛选,有 64 篇文章被接受进一步分析(=25294 名参与者)。随机效应汇总估计显示,污名与幸福感之间存在总体上的负相关和中等强度的关联(r=-.31,95%置信区间[-.35;-.26])。参与者的年龄改变了这种效应,年龄较大的 PLWH 之间的关联更强。其他社会人口学和临床变量以及发表年份和污名测量并不能解释研究之间污名与幸福感关联的变化。

结论

本荟萃分析和系统评价不仅显示了预期的污名与幸福感之间的负相关关系,还揭示了研究之间存在大量的异质性,这表明特定研究的背景起着重要作用。这一发现呼吁采用更先进的理论和分析模型,以确定保护和脆弱因素,并在临床实践和干预中有效地加以解决。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/569f/8635597/62e501de6860/ZEPT_A_1990527_F0001_OC.jpg

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