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社会对 COVID-19 疾病的污名化:肯尼亚西部的中小学校长和感染 HIV 的青少年的看法。

Social Stigma Related to COVID-19 Disease Described by Primary and Secondary School Teachers and Adolescents Living With HIV in Western Kenya.

机构信息

Department of Global Health and Health System Design, Arnhold Institute for Global Health, Icahn School of Medicine at Mount Sinai, New York, NY, United States.

Department of Child Health and Paediatrics, School of Medicine, College of Health Sciences, Moi University, Eldoret, Kenya.

出版信息

Front Public Health. 2021 Nov 17;9:757267. doi: 10.3389/fpubh.2021.757267. eCollection 2021.

Abstract

Understanding community members' knowledge, attitudes, and beliefs about the novel SARS-CoV-2 virus and the prevalence of associated stigma are critical steps for increasing accurate public health knowledge, encouraging uptake of preventative or mitigating health behaviors, and ultimately bringing the COVID-19 pandemic under control. We conducted a one-time, phone-based assessment to assess the presence of perceived COVID-19 community stigma reported by Kenyan primary and secondary school teachers, as well as adolescents living with HIV. Participants were previously enrolled in an ongoing, cluster-randomized trial to evaluate the impact of multi-media teacher training on teachers' negative attitudes and beliefs around HIV. The SAFI Stigma Questionnaire, a validated tool to assess HIV-related stigma in this setting, was adapted to ask questions regarding the stigma and discrimination experienced or perceived during the COVID-19 pandemic. We enrolled 330 participants in this study, including 311 primary and secondary teachers (56% female, average age 36 years) and 19 adolescents living with HIV (57.89% female, average age 16.37 years). None of the adolescent participants reported witnessing or experiencing discrimination related to COVID-19, nor did they report losing financial and/or social support. In contrast, the teacher participants reported prominent social stigma experiences of various levels and related to COVID-19. Teachers in the intervention group, who had completed the multi-media training on HIV-related stigma, were significantly less likely to think that the community viewed COVID-19 as a dirty or shameful disease, and less likely to feel it was important to keep their COVID-19 infection a secret, compared to the teacher control group. These findings suggest that COVID-19-related stigma may be prevalent in western Kenya and that interventions to reduce community-level stigma for HIV may also have a protective impact on other stigmatized infectious diseases such as COVID-19.

摘要

了解社区成员对新型 SARS-CoV-2 病毒的知识、态度和信念,以及与该病毒相关的污名的普遍程度,是增加公众对准确公共卫生知识的了解、鼓励采取预防或缓解健康行为的关键步骤,最终可以控制 COVID-19 大流行。我们进行了一次性的电话评估,以评估肯尼亚中小学教师和感染艾滋病毒的青少年所报告的感知 COVID-19 社区污名的存在。参与者先前参加了一项正在进行的、基于群组的试验,以评估多媒体教师培训对教师对艾滋病毒的负面态度和信念的影响。SAFI 污名问卷是一种在该环境中评估与艾滋病毒相关的污名的经过验证的工具,经过改编,用于询问在 COVID-19 大流行期间经历或感知到的污名和歧视问题。我们在这项研究中招募了 330 名参与者,包括 311 名中小学教师(56%为女性,平均年龄 36 岁)和 19 名感染艾滋病毒的青少年(57.89%为女性,平均年龄 16.37 岁)。没有青少年参与者报告目睹或经历与 COVID-19 相关的歧视,也没有报告失去经济和/或社会支持。相比之下,教师参与者报告了各种程度的突出的与 COVID-19 相关的社会污名经历。参加过关于艾滋病毒相关污名的多媒体培训的干预组教师,与对照组教师相比,他们认为社区将 COVID-19 视为肮脏或可耻的疾病的可能性较小,认为隐瞒 COVID-19 感染的重要性也较小。这些发现表明,与 COVID-19 相关的污名可能在肯尼亚西部很普遍,并且减少社区层面针对艾滋病毒的污名的干预措施也可能对其他受污名化的传染病如 COVID-19 产生保护作用。

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