Heckman T G, Somlai A M, Peters J, Walker J, Otto-Salaj L, Galdabini C A, Kelly J A
Department of Psychiatry and Behavioral Medicine, Medical College of Wisconsin, Milwaukee 53226, USA.
AIDS Care. 1998 Jun;10(3):365-75. doi: 10.1080/713612410.
People living with HIV disease, particularly those in small towns and rural areas, face many barriers that prevent them from receiving important life-care services. We developed the Barriers to Care Scale (BACS) to delineate the problem severity of factors that impede care and service provision among a sample of 226 men and women living with HIV disease in a single midwestern state. Both urban and rural respondents indicated that major barriers to life-care services included the lack of knowledge about HIV among citizens in the community, insufficient personal financial resources, the lack of employment opportunities for people living with HIV, and the lack of supportive and understanding work environments. Rural persons living with HIV disease, compared to their urban counterparts, assigned significantly higher problem severity ratings to the following barriers: the need to travel long distances to medical facilities and personnel; a shortage of adequately trained medical and mental health professionals; a lack of personal or public transportation; and community residents' stigma toward people living with HIV. The large number of barriers to care identified in the present study indicates that innovative programmes designed to remove these barriers and improve the life quality of rural persons living with HIV are urgently needed.
感染艾滋病毒的人，尤其是那些生活在小镇和农村地区的人，面临着许多阻碍他们获得重要生活护理服务的障碍。我们开发了护理障碍量表（BACS），以描述在中西部一个州的226名感染艾滋病毒的男性和女性样本中，阻碍护理和服务提供的因素的问题严重程度。城市和农村的受访者均表示，生活护理服务的主要障碍包括社区居民对艾滋病毒缺乏了解、个人财务资源不足、艾滋病毒感染者缺乏就业机会以及缺乏支持性和理解性的工作环境。与城市的艾滋病毒感染者相比，农村的艾滋病毒感染者对以下障碍的问题严重程度评分显著更高：前往医疗设施和人员处需要长途跋涉；缺乏训练有素的医疗和心理健康专业人员；缺乏个人或公共交通工具；以及社区居民对艾滋病毒感染者的污名化。本研究中确定的大量护理障碍表明，迫切需要设计创新方案来消除这些障碍并提高农村艾滋病毒感染者的生活质量。
