School of Politics and Public Administration, Guangxi Normal University, Guilin, 541006, Guangxi, China.
AIDS Behav. 2023 Jul;27(7):2411-2429. doi: 10.1007/s10461-022-03968-z. Epub 2022 Dec 29.
HIV disclosure is crucial for HIV prevention and control, but may also lead to discrimination, insult, and even violence against people living with HIV and AIDS (PLWHAs). In this study, we examined HIV disclosure, its influencing factors, and its association with intimate partner violence (IPV) among 1153 PLWHAs through the sexual route in Jinan, Shandong Province, China. Our results showed that 76.4% (881/1153) PLWHAs had disclosed someone about their HIV infection, the HIV disclosure rates among family members, friends, spouses, and current fixed partners of PLWHAs were 43.5% (501/1153), 47.9% (552/1153), 56.8% (129/227), and 43.2% (336/777), respectively. HIV disclosure was affected by socio-demographics, disease characteristics, and psycho-social factors and varied among family members, close friends, spouses, and current fixed sexual partners. Age ≤ 33 years (aOR 1.79, 95% CI 1.27-2.53), heterosexual infection route (aOR 1.52, 95% CI 1.06-2.17), HIV diagnosis time > 36 months (aOR 1.84, 95% CI 1.30-2.59), with other chronic diseases (aOR 1.87, 95% CI 1.34-2.61), lower self-stigma (aOR 4.03-4.36, 95% CI 1.98-8.74), higher social support (aOR 1.71-1.73, 95% CI 1.03-2.83), no depression (aOR 1.54, 95% CI 1.12-2.11), and no suicidal ideation (aOR 1.79, 95% CI 1.28-2.50) were all independently associated with increased likelihood of HIV disclosure. HIV disclosure was associated with an increased risk of IPV among current fixed sexual partners (aOR 1.87, 95% CI 1.38-2.54) and spouses (aOR 2.54, 95% CI 1.41-4.56). Our findings suggest that the HIV disclosure rate of PLWHAs is still low and is affected by multiple factors. There is an urgent need to design targeted and comprehensive interventions to improve HIV disclosure. IPV prevention should also be incorporated into the intervention system of HIV disclosure to ensure adequate and continuous support for PLWHAs.
艾滋病毒披露对于艾滋病毒的预防和控制至关重要，但也可能导致对艾滋病毒感染者和艾滋病患者（PLWHAs）的歧视、侮辱，甚至暴力。在这项研究中，我们通过性途径调查了山东省济南市的 1153 名 PLWHAs 的艾滋病毒披露情况、影响因素及其与亲密伴侣暴力（IPV）的关系。我们的研究结果显示，76.4%（881/1153）的 PLWHAs 向他人透露了自己的艾滋病毒感染情况，PLWHAs 的家庭成员、朋友、配偶和当前固定性伴侣中 HIV 披露率分别为 43.5%（501/1153）、47.9%（552/1153）、56.8%（129/227）和 43.2%（336/777）。HIV 披露受到社会人口统计学、疾病特征和心理社会因素的影响，并且在家庭成员、亲密朋友、配偶和当前固定性伴侣之间存在差异。年龄≤33 岁（aOR 1.79，95%CI 1.27-2.53）、异性传播途径（aOR 1.52，95%CI 1.06-2.17）、HIV 诊断时间>36 个月（aOR 1.84，95%CI 1.30-2.59）、伴有其他慢性病（aOR 1.87，95%CI 1.34-2.61）、自我污名化程度较低（aOR 4.03-4.36，95%CI 1.98-8.74）、社会支持度较高（aOR 1.71-1.73，95%CI 1.03-2.83）、无抑郁（aOR 1.54，95%CI 1.12-2.11）和无自杀意念（aOR 1.79，95%CI 1.28-2.50）与增加 HIV 披露的可能性独立相关。HIV 披露与当前固定性伴侣（aOR 1.87，95%CI 1.38-2.54）和配偶（aOR 2.54，95%CI 1.41-4.56）中的 IPV 风险增加相关。我们的研究结果表明，PLWHAs 的 HIV 披露率仍然较低，受到多种因素的影响。迫切需要设计有针对性和全面的干预措施来提高 HIV 披露率。还应将 IPV 预防纳入 HIV 披露干预系统，以确保为 PLWHAs 提供充足和持续的支持。
