Faculty of Public Health, Chiang Mai University, Chiang Mai, Thailand.
School of Pharmacy, Monash University Malaysia, Bandar Sunway, Malaysia.
AIDS Patient Care STDS. 2022 May;36(5):186-193. doi: 10.1089/apc.2022.0035.
HIV-related stigma and discrimination have been a significant barrier to accessing health care, hence contributing to poor health outcomes. This study aimed to investigate factors associated with HIV-related stigma and discrimination and health-related quality of life (HRQoL) among people living with HIV in rural Thailand setting. A cross-sectional convenience sample of 161 HIV-positive Thai patients was recruited from a single rural district hospital using a self-administered questionnaire entailing sociodemographic information, the 12-item stigma scale, the Medical Outcomes Study HIV Health Survey (MOS-HIV), and the EuroQoL 5-Dimension 5-Level (EQ-5D-5L). Linear regression and the multi-variable analyses were used to investigate factors associated with stigma and HRQoL, whereas the correlations between stigma and quality of life variables were tested by Pearson correlations. Being married and duration of antiretroviral therapy were negatively correlated with HIV stigma, while increased age was inversely associated with HRQoL. Being employed and having sufficient money for living contributed positively to predict HRQoL. HIV stigma was negatively associated with mental health summary (MHS) and visual analog scale (VAS) score, whereas duration diagnosed with HIV and the use of two nucleoside reverse transcriptase inhibitors in combination with protease inhibitor regimen were negative factors associated with VAS and health utility, respectively. The findings confirm complex and inseparable associations of factors relating to HIV-related stigma and HRQoL. The development of effective interventions tailored at individual level is warranted to address this gap.
HIV 相关耻辱和歧视一直是获得医疗保健的重大障碍,从而导致健康状况不佳。本研究旨在调查与泰国农村地区 HIV 感染者相关耻辱和歧视以及与健康相关的生活质量(HRQoL)相关的因素。采用横断面便利抽样法,从一家农村地区医院招募了 161 名 HIV 阳性泰国患者,使用自我管理问卷,包括社会人口统计学信息、12 项耻辱量表、医疗结局研究 HIV 健康调查(MOS-HIV)和 EuroQoL 5 维度 5 级(EQ-5D-5L)。线性回归和多变量分析用于调查与耻辱和 HRQoL 相关的因素,而耻辱和生活质量变量之间的相关性则通过 Pearson 相关性进行测试。已婚和接受抗逆转录病毒治疗的时间与 HIV 耻辱感呈负相关,而年龄增加与 HRQoL 呈负相关。就业和有足够的生活资金有助于预测 HRQoL。HIV 耻辱感与心理健康综合评分(MHS)和视觉模拟评分(VAS)呈负相关,而 HIV 诊断时间和使用两种核苷逆转录酶抑制剂联合蛋白酶抑制剂方案与 VAS 和健康效用呈负相关。研究结果证实了与 HIV 相关耻辱和 HRQoL 相关的因素之间复杂且不可分割的关系。需要制定针对个体的有效干预措施来解决这一差距。