Stigma is associated with delays in seeking care among HIV-infected people in India.
Stigma is associated with delays in seeking care among HIV-infected people in India.
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DOI：
10.1177/1545109711432315
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发表时间：
2013-03
影响因子：
--
通讯作者：
Ekstrand ML
中科院分区：
文献类型：
--
作者：
Steward WT;Bharat S;Ramakrishna J;Heylen E;Ekstrand ML
耻辱塑造了艾滋病毒感染者的生活，并可能影响他们寻求医疗服务的意愿。但治疗延误会损害健康，并增加传播给他人的风险。研究四种病耻感表现形式——颁布的（歧视）、间接的（听到歧视的故事）、感觉规范的（对病耻感的普遍认知）和内化的（对病耻感信念的个人认可）——是否与印度艾滋病毒感染者寻求治疗的延迟有关。对孟买和班加罗尔的961名艾滋病毒阳性男性和女性进行了横断面调查。制定和内化的耻辱感与艾滋病毒检测呈阳性后寻求护理的延迟相关。抑郁症状介导了外在污名和内化污名与求医延迟之间的关联，而努力避免披露艾滋病毒状况仅介导了内化污名与求医延迟之间的关联。制定减少耻辱感的干预措施以确保及时获得治疗至关重要。
Stigma shapes the lives of people living with HIV and may affect their willingness to seek medical care. But treatment delays can compromise health and increase the risk of transmission to others. To examine whether four stigma manifestations—enacted (discrimination), vicarious (hearing stories of discrimination), felt normative (perceptions of stigma’s prevalence) and internalized (personal endorsement of stigma beliefs)—were linked with delays in seeking care among HIV-infected people in India. A cross-sectional survey was conducted with 961 HIV-positive men and women in Mumbai and Bengaluru. Enacted and internalized stigmas were correlated with delays in seeking care after testing HIV-positive. Depression symptoms mediated the associations of enacted and internalized stigmas with care seeking delays, whereas efforts to avoiding disclosing HIV status mediated only the association between internalized stigma and care seeking delays. It is vital to develop stigma reduction interventions to ensure timely receipt of care.