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HIV/AIDS 污名化水平及其在埃塞俄比亚性活跃人群中的相关因素:基于 2016 年埃塞俄比亚人口与健康调查数据的分析。

Levels of HIV/AIDS stigma and associated factors among sexually active Ethiopians: analysis of 2016 Ethiopian Demographic and Health Survey Data.

机构信息

Department of Statistics, College of Natural & Computational Sciences, Addis Ababa University, Addis Ababa, Ethiopia.

Department of Epidemiology, Institute of Health, Faculty of Public Health, Jimma University, Oromia, Jimma, Ethiopia.

出版信息

BMC Public Health. 2022 May 31;22(1):1080. doi: 10.1186/s12889-022-13505-1.

Abstract

BACKGROUND

Stigma and discrimination have fueled the transmission of the disease and dramatically increased its negative public health impact. Even though the disease has extremely ravaged human life, stigma, and discrimination attached to it are not well addressed in Ethiopia at the country level. The reduction of stigma and discrimination in a population are important indicators of the success of programs that target HIV prevention and control. This study aimed to assess the level of HIV-related stigma and its determinants among sexually active Ethiopians.

METHODS

A public domain data were obtained from 2016 Ethiopian Demographic and Health Survey in which two-stage cross-sectional stratified cluster sampling was applied. A total of 28,371 sexually active Ethiopians were interviewed from both rural and urban parts of Ethiopia. Descriptive Statistics and multilevel ordinal logistic regression (proportional odds model) were used to summarize data and to investigate correlates of HIV-related stigma.

RESULTS

Only 5.1% (95% CI: 4.5%, 5.8%) of sexually active Ethiopians did not have a stigmatizing attitude, whereas, 59.2% (95% CI: 57.3%, 61.1%) and 35.65% (95% CI: 33.5%, 37.9%) of them had a moderate and high level of stigma respectively. Regression results show that residence (AOR = 1.82, 95% CI:1.46, 2.27), education (AOR = 0.65,95% CI: 0.50,0.84), owning mobile (AOR = 0.63,95% CI:0.55,0.72), HIV-testing (AOR = 0.77, 95% CI:0.70,0.84), age (AOR = 0.81, 95% CI: 0.73, 0.91), religion (AOR = 1.53,95% CI:1.33,1.76), and marital status (AOR = 1.38, 95% CI:1.19, 1.61) were significantly associated with HIV-related stigma (p < 0.0001).

CONCLUSION

Regardless of all efforts put in a place to prevent and control HIV, a significant proportion of sexually active Ethiopians have stigmatizing attitudes. Residence, educational level, owning mobile, HIV test uptake, age, religion, and marital status were determinants of HIV-related stigma. Expanding mobile coverage, promoting HIV counseling and tests, promoting HIV education, and working with religious leaders, among other strategies could be used to minimize the stigma attached to the disease to best prevent and control it.

摘要

背景

污名化和歧视加剧了疾病的传播,极大地增加了其对公共卫生的负面影响。尽管该疾病对人类生命造成了极大的破坏,但埃塞俄比亚在国家层面上并未很好地解决与该疾病相关的污名化和歧视问题。减少人群中的污名化和歧视是针对艾滋病毒预防和控制的项目成功的重要指标。本研究旨在评估埃塞俄比亚性活跃人群中与艾滋病毒相关的污名化程度及其决定因素。

方法

本研究使用了 2016 年埃塞俄比亚人口与健康调查中的公开数据,该调查采用了两阶段分层整群随机抽样。共对来自埃塞俄比亚城乡地区的 28371 名性活跃的埃塞俄比亚人进行了访谈。采用描述性统计和多水平有序逻辑回归(比例优势模型)来总结数据,并调查与艾滋病毒相关的污名化的相关因素。

结果

仅有 5.1%(95%CI:4.5%,5.8%)的性活跃的埃塞俄比亚人没有歧视态度,而 59.2%(95%CI:57.3%,61.1%)和 35.65%(95%CI:33.5%,37.9%)的人有中度和高度的污名化。回归结果显示,居住地(AOR=1.82,95%CI:1.46,2.27)、教育程度(AOR=0.65,95%CI:0.50,0.84)、拥有移动电话(AOR=0.63,95%CI:0.55,0.72)、艾滋病毒检测(AOR=0.77,95%CI:0.70,0.84)、年龄(AOR=0.81,95%CI:0.73,0.91)、宗教信仰(AOR=1.53,95%CI:1.33,1.76)和婚姻状况(AOR=1.38,95%CI:1.19,1.61)与与艾滋病毒相关的污名化显著相关(p<0.0001)。

结论

尽管在预防和控制艾滋病毒方面做出了各种努力,但仍有相当一部分性活跃的埃塞俄比亚人持有歧视态度。居住地、教育水平、拥有移动电话、艾滋病毒检测、年龄、宗教信仰和婚姻状况是与艾滋病毒相关的污名化的决定因素。扩大移动电话的覆盖范围、促进艾滋病毒咨询和检测、推广艾滋病毒教育以及与宗教领袖合作等策略可用于最大限度地减少与该疾病相关的污名化,以最佳地预防和控制该疾病。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/45f1/9158254/7543c5da43f8/12889_2022_13505_Fig1_HTML.jpg

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