Faculty of Public Health, Chiang Mai University, Chiang Mai, Thailand.
Departments of Internal Medicine and Anthropology, University of Michigan, Michigan, USA.
J Glob Health. 2023 Jan 14;13:04006. doi: 10.7189/jogh.13.04006.
Thailand has an ongoing action plan to reduce human immunodeficiency virus (HIV) discrimination and stigma. We aimed to monitor the level of stigmatizing and discriminatory attitudes toward people living with HIV/AIDS (PLWHA) among the general adult population and to investigate its related factors.
This study was based on data from the 6 Thai National Health Examination Survey, a large-scale country-wide survey in 2019-2020. We used a multistage sampling technique and included 11 843 adults aged 20 to 59. We collected data through face-to-face interviews which included six items related to HIV stigma domains. We weighted all analyses to account for the probability of sampling the Thai population aged 20 to 59 years.
We found that anticipated stigma had the highest percentage of negative stigmatizing attitude responses (78.5%), followed by perceived stigma (66.6%), fear of HIV infection (54.4%), and social judgment (28.2%). Regarding the UNAIDS global indicator for discriminatory attitude, 48.6% of respondents had negative perceptions to questions about experienced stigma or discrimination. Multiple logistic regression showed that factors associated with discriminatory attitudes toward PLWHA were being aged 20-39 (adjusted odds ratio (aOR) = 1.32, 95% confidence interval (CI) = 1.18-1.47) or 50-59 (aOR = 1.23, 95% CI = 1.09-1.40) compared to being aged 40-49, being Muslim compared to Buddhist (aOR = 1.73, 95% CI = 1.46-2.06), being married compared to being single (aOR = 1.15, 95% CI = 1.04-1.28), holding certificate degree or higher compared to not studying or studying at a primary level (aOR = 0.81, 95% CI = 0.68-0.97), living in the Northeast (aOR = 1.27, 95% CI = 1.12-1.45) and Bangkok (aOR = 1.30, 95% CI = 1.12-1.51) compared to living in the North, having no HIV/AIDS infected relative or acquaintance compared to having an HIV/AIDS infected relative or acquaintance (aOR = 1.56, 95% CI = 1.41-1.73), and not obtaining an HIV test compared to obtaining it (aOR = 1.10, 95% CI = 1.02-1.19).
We found that HIV stigmatizing and discriminatory attitudes toward PLWHA decreased, but remained concerning among Thai adult people. A public education and awareness campaign, as well as an intervention to reduce HIV-related stigma and discrimination in the country's health care facilities, must still be maintained.
泰国正在实施一项行动计划，以减少针对艾滋病毒（HIV）感染者的歧视和污名。我们旨在监测普通成年人群体中对艾滋病毒/艾滋病感染者（PLWHA）的污名化和歧视态度的水平，并调查其相关因素。
本研究基于 2019-2020 年泰国国家健康检查调查的 6 项数据，这是一项全国范围内的大规模调查。我们使用多阶段抽样技术，纳入了 11843 名年龄在 20 至 59 岁的成年人。我们通过面对面访谈收集数据，其中包括与 HIV 污名领域相关的六个项目。我们对所有分析进行加权，以考虑到对年龄在 20 至 59 岁的泰国人口进行抽样的概率。
我们发现，预期污名的负面污名化态度比例最高（78.5%），其次是感知污名（66.6%）、对 HIV 感染的恐惧（54.4%）和社会判断（28.2%）。关于联合国艾滋病规划署的歧视性态度全球指标，48.6%的受访者对经历污名或歧视的问题持负面看法。多因素逻辑回归显示，与对 PLWHA 的歧视性态度相关的因素包括年龄在 20-39 岁（调整后的优势比[aOR]为 1.32，95%置信区间[CI]为 1.18-1.47）或 50-59 岁（aOR 为 1.23，95%CI 为 1.09-1.40），与 40-49 岁相比，穆斯林与佛教徒（aOR 为 1.73，95%CI 为 1.46-2.06）相比，已婚与单身（aOR 为 1.15，95%CI 为 1.04-1.28）相比，持有证书或更高学历与未学习或仅接受小学教育（aOR 为 0.81，95%CI 为 0.68-0.97）相比，与居住在东北部（aOR 为 1.27，95%CI 为 1.12-1.45）和曼谷（aOR 为 1.30，95%CI 为 1.12-1.51）相比，居住在北部，与有 HIV/AIDS 感染者的亲戚或熟人相比（aOR 为 1.56，95%CI 为 1.41-1.73），与没有进行 HIV 检测相比（aOR 为 1.10，95%CI 为 1.02-1.19）。
我们发现，泰国成年人群体中对 PLWHA 的 HIV 污名化和歧视态度有所下降，但仍令人关注。必须继续在该国的卫生保健机构中开展公众教育和宣传活动，以及干预措施，以减少与 HIV 相关的污名和歧视。
