尼日利亚艾滋病毒感染者社会支持的决定因素：一项多中心横断面研究。
Determinants of social support among people living with HIV in Nigeria-a multicenter cross-sectional study.
机构信息
Lagos State Primary Healthcare, Lagos, Nigeria.
Institute of Human Virology, Usmanu Danfodiyo University Teaching Hospital, Sokoto, Nigeria.
出版信息
Front Public Health. 2023 Jun 15;11:1120192. doi: 10.3389/fpubh.2023.1120192. eCollection 2023.
BACKGROUND
More than 38.4 million people were living with HIV worldwide in 2021. Sub-Saharan Africa bears two-thirds of the burden, with Nigeria having nearly two million people living with HIV (PLWH). Social support from social networks such as family and friends improve the quality of life, and reduces enacted and perceived stigma, but social support for PLWH remains suboptimal in Nigeria. This study aimed to assess the prevalence of social support and associated factors among PLWH in Nigeria and to test whether stigma reduces types of social support.
METHODS
This cross-sectional study was conducted in Lagos State, Nigeria, between the months of June and July 2021. A total of 400 PLWH were surveyed across six health facilities providing antiretroviral therapy. Social support (family, friends, and significant others) and stigma were measured with the Multidimensional Scale of Perceived Social Support and Berger's HIV Stigma Scale, respectively. Binary logistic regression was used to identify determinants of social support.
RESULTS
More than half (50.3%) of the respondents had adequate social support overall. The prevalence of family, friends, and significant others support was 54.3, 50.5, and 54.8%, respectively. Stigma (Adjusted Odds Ratio [AOR]: 0.945; 95% Confidence Interval [CI]: 0.905-0.987) was negatively associated with adequate friend support. Female gender (AOR: 6.411; 95% CI: 1.089-37.742), higher income (AOR: 42.461; 95% CI: 1.452-1241.448), and seropositive disclosure (AOR: 0.028; 95% CI: 0.001-0.719) were associated with adequate significant others support. Stigma (AOR:0.932; 95% CI: 0.883-0.983) was negatively associated with adequate support overall. Our findings corroborate the social support theory, as stigma reduces the chance of receiving social support.
CONCLUSION
PLWH that enjoy support from families or friends were less likely to be affected by HIV-related stigma. More support is needed by PLWH from family, friends, and significant others to improve the quality of life and reduce stigma among PLWH in Lagos State.
背景
2021 年，全球有超过 3840 万人感染艾滋病毒。撒哈拉以南非洲地区承担了三分之二的负担，其中尼日利亚有近 200 万人感染艾滋病毒（PLWH）。来自家庭和朋友等社交网络的社会支持可以提高生活质量，减少实施和感知到的耻辱感，但尼日利亚 PLWH 的社会支持仍然不理想。本研究旨在评估尼日利亚 PLWH 的社会支持现状及其相关因素，并检验耻辱感是否会降低社会支持的类型。
方法
本横断面研究于 2021 年 6 月至 7 月在尼日利亚拉各斯州的六家提供抗逆转录病毒治疗的医疗机构进行。共有 400 名 PLWH 接受了调查。社会支持（家庭、朋友和重要他人）和耻辱感分别用多维感知社会支持量表和 Berger 的 HIV 耻辱量表进行测量。采用二项逻辑回归分析确定社会支持的决定因素。
结果
超过一半（50.3%）的受访者总体上得到了足够的社会支持。家庭、朋友和重要他人支持的比例分别为 54.3%、50.5%和 54.8%。耻辱感（调整后的优势比[OR]：0.945；95%置信区间[CI]：0.905-0.987）与足够的朋友支持呈负相关。女性（OR：6.411；95%CI：1.089-37.742）、较高收入（OR：42.461；95%CI：1.452-1241.448）和血清阳性披露（OR：0.028；95%CI：0.001-0.719）与足够的重要他人支持有关。耻辱感（OR：0.932；95%CI：0.883-0.983）与总体上足够的支持呈负相关。我们的研究结果证实了社会支持理论，即耻辱感降低了获得社会支持的机会。
结论
那些得到家庭或朋友支持的 PLWH 受到 HIV 相关耻辱感的影响较小。PLWH 需要从家庭、朋友和重要他人那里获得更多的支持，以提高生活质量并减少拉各斯州 PLWH 的耻辱感。
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