Hall Wendasha Jenkins, McCree Donna Hubbard, Beer Linda, Luo Qingwei, Carter Brittani
Department of Health Promotion and Physical Education, Kennesaw State University, Kennesaw, GA, USA.
Division of HIV/AIDS Prevention, Centers for Disease Control and Prevention, Atlanta, GA, USA.
AIDS Care. 2023 Mar;35(3):325-333. doi: 10.1080/09540121.2022.2141183. Epub 2022 Nov 3.
Research that explores the intra-racial socio-demographic and clinical characteristics associated with perceived discrimination in healthcare settings in the US is lacking. We examined the prevalence of self-reported discrimination in HIV care settings during the past 12 months among Black persons from a nationally representative sample of US adults with diagnosed HIV collected 6/2018-5/2019. We assessed the prevalence of self-reported discrimination in HIV care settings during the past 12 months, perceived reasons for discrimination, and factors associated with discrimination among Black persons with diagnosed HIV ( = 1,631). Overall, 22% reported experiencing discrimination in a healthcare setting; discrimination was most often attributed to HIV status. Those reporting discrimination were younger, MSM, and living at or below the federal poverty level. They also experienced homelessness, incarceration and illicit substance use in the past 12 months, and anxiety and depression symptoms in the past 2 weeks. They were less likely to use ART or report 100% ART dose adherence in the past 30 days. No associations were found with viral suppression. Systems are needed to monitor, evaluate reports of, and address discrimination in healthcare settings. Incorporating anti-discrimination policies and continuing education opportunities for providers and staff may reduce experiences of discrimination among persons with HIV.
在美国,缺乏探索与医疗环境中感知到的歧视相关的种族内部社会人口统计学和临床特征的研究。我们调查了2018年6月至2019年5月期间从全国代表性的美国成年HIV确诊患者样本中抽取的黑人在过去12个月中,在HIV护理环境中自我报告的歧视发生率。我们评估了过去12个月中在HIV护理环境中自我报告的歧视发生率、感知到的歧视原因以及与确诊HIV的黑人(=1631)中歧视相关的因素。总体而言,22%的人报告在医疗环境中遭受过歧视;歧视最常归因于HIV感染状况。报告遭受歧视的人更年轻,是男男性行为者,且生活在联邦贫困线及以下。他们在过去12个月中还经历过无家可归、监禁和非法药物使用,在过去2周内有焦虑和抑郁症状。他们在过去30天内使用抗逆转录病毒治疗(ART)或报告100%ART剂量依从性的可能性较小。未发现与病毒抑制存在关联。需要建立系统来监测、评估医疗环境中的歧视报告并加以解决。为医护人员和工作人员纳入反歧视政策和继续教育机会,可能会减少HIV感染者遭受歧视的经历。