老年HIV感染者/AIDS病人自我羞耻感、歧视水平及影响因素研究

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目的了解永州市老年HIV感染者/AIDS病人(PLWHA)自我羞耻感和歧视水平现状,并分析其影响因素,为今后老年艾滋病防控提供依据。方法从全国艾滋病疫情报告系统中下载1993-2013年现住址为永州市的现存活的老年HIV感染者和AIDS病人的历史卡片。在自愿的原则下,用自拟的调查问卷对研究对象进行一对一问卷调查。结果共收集318份有效问卷。结果显示,老年PLWHA的自我感知的羞耻和歧视的得分总分为(31.01±9.03),其中社交距离、自责、偏见三个维度得分分别是(9.79±3.33)、(12.69±3.01)、(8.53±2.94)。在不同特征老年PLWHA自我感知的羞耻和歧视的得分中:汉族的PLWHA的自我感知的羞耻和歧视的得分总分明显高于瑶族和其他族,差异有统计学意义(F=21.085,P<0.001),且汉族的PLWHA在社交距离、自责、偏见分量表的得分也明显高于其他民族;离异/丧偶的PLWHA的自我感知羞耻和歧视的总分最高,其次是在婚/同居,未婚的PLWHA的总分得分最低,差异有统计学意义(F=5.052,P<0.05);独自一人居住的PLWHA的自我感知的羞耻和歧视总分得分最高,并且在社交距离和偏见分量表中,独自一人居住的PLWHA的得分最高。随着年可支配收入的增加,感到的羞耻和歧视程度越高,差异有统计学意义(F=8.968,P<0.05)。对于现在所从事的工作情况,羞耻和歧视总分得分由高到低依次为:在家休养、在家搞种植、打工或做生意,差异有统计学意义(F=8.635,P<0.05)。配偶和子女对PLWHA的HIV感染情况知晓的自我感知的羞耻和歧视得分最高,其次是配偶知道、家人都不知道、所有子女知道,得分最低的是所有子女知道感染情况,差异有统计学意义(F=6.500,P<0.05)。结论不同民族、婚姻状况、居住状况、每年可支配收入情况、目前的工作状况和家庭成员对患者感染状况的知晓情况对老年PLWHA自我羞耻感及歧视水平有影响。其中,汉族、年可支配收入高的、离异/丧偶的、独自一人居住的、在家休养的、配偶和子女知晓PLWHA的HIV感染情况的老年PLWHA自我羞耻感及歧视水平得分最高。 Objective To understand the current status of self-stigma and discrimination in elderly HIV-infected / AIDS patients (PLWHA) in Yongzhou and to analyze the influencing factors for the prevention and control of geriatric AIDS in the future. Methods From the National AIDS Epidemiological Reporting System, the historical cards of the existing live elderly HIV-infected and AIDS patients living in Yongzhou from 1993 to 2013 were downloaded. Under the principle of voluntariness, one-on-one questionnaires were conducted on the subjects using self-designed questionnaires. Results A total of 318 valid questionnaires were collected. The results showed that the total score of self-perceived shame and discrimination in old PLWHA was (31.01 ± 9.03), the scores of social distance, self-blame and prejudice were (9.79 ± 3.33), (12.69 ± 3.01), 8.53 ± 2.94). Among the scores of self-perceived shame and discrimination among PLWHA with different characteristics, Han’s PLWHA self-perceived shame and discrimination scores were significantly higher than those of Yao and other ethnic groups (F = 21.085, P <0.001) ), And PLWHA scores of Han people in social distance, self-reproach and prejudice scale were also significantly higher than other nationalities; PLWHA divorced / widowed the highest self-perceived shame and discrimination, followed by married / cohabiting, unmarried PLWHA had the lowest total score, with a significant difference (F = 5.052, P <0.05). PLWHA, who lived alone, had the highest self-perceived shame and discrimination scores, and had a significantly higher self-perceived score on social distance and bias alone PLWHA, who lives in the highest score. As annual disposable income increased, the higher the level of shame and discrimination, the difference was statistically significant (F = 8.968, P <0.05). The scores of total scores of shame and discrimination for the current work are as follows: recuperation at home, cultivation at home, work or business, the difference was statistically significant (F = 8.635, P <0.05). Spouses and children have the highest self-perceived shame and discrimination awareness of HIV infection in PLWHA, followed by spouses know that their families do not know, all children know that the lowest score is all children know the infection, the difference was statistically significant ( F = 6.500, P <0.05). Conclusion The effects of different ethnic groups, marital status, living conditions, annual disposable income, current working conditions and family members’ awareness of patient’s infection have an impact on self-reported PLWHA self-stigma and discrimination. Among them, the Han nationality, PLWHA, with high annual disposable income, divorced / widowed, living alone and residing at home, scored the highest self-reported stigma and discrimination among spouses and children with PLWHA’s HIV status.
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