Determinants of stigma among patients with hepatitis C virus infection.
Determinants of stigma among patients with hepatitis C virus infection.
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DOI：
10.1111/jvh.13343
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发表时间：
2020-11
影响因子：
2.5
通讯作者：
Lo Re, Vincent, III
中科院分区：
文献类型：
--
作者：
Saine, M. Elle;Szymczak, Julia E.;Moore, Tyler M.;Bamford, Laura P.;Barg, Frances K.;Schnittker, Jason;Holmes, John H.;Mitra, Nandita;Lo Re, Vincent, III
围绕丙型肝炎病毒（HCV）感染的污名是一个重要的和未充分研究的障碍，丙型肝炎病毒的治疗和消除。HCV相关污名的决定因素，包括HCV治疗阶段的影响（即，自发清除;诊断，未治疗;以前治疗过，没有治愈;目前正在治疗中;治疗，治愈）和合并感染人类免疫缺陷病毒（艾滋病毒），仍然未知。为了解决这些差距，我们在2018年7月至2019年5月在费城门诊诊所有HCV感染史的患者（n=270）中进行了一项横断面研究。我们使用经验证的HCV污名量表（改编自Berger HIV污名量表）评估污名。HCV相关污名与假设的人口统计学、行为学和临床危险因素之间的关系通过多变量线性回归进行评估。大多数参与者（95.5%）经历了HCV相关的耻辱。HCV单感染者和HIV/HCV合并感染者的平均耻辱得分无显著差异（P=0.574）。然而，我们观察到艾滋病毒状态和多个决定因素之间的显着相互作用，因此，我们分层分析艾滋病毒状态。在HIV/HCV合并感染的参与者中，既往HCV治疗未治愈，女性，西班牙裔/拉丁裔种族和一些大学教育与较高的HCV耻辱评分显著相关。年收入在10，000 - 40，000美元之间的人，耻辱感得分显著降低。在HCV单一感染者中未观察到显著相关性。我们发现，大多数参与者经历了与HCV诊断相关的耻辱。虽然HCV单一感染者和HIV/HCV合并感染者的耻辱感评分相似，但与HCV耻辱感相关的决定因素因HIV状态而异。了解HCV单一感染和HIV/HCV合并感染患者之间的耻辱感差异可能有助于制定针对HCV流行的干预措施。
Stigma around hepatitis C virus (HCV) infection is an important and understudied barrier to HCV treatment and elimination. The determinants of HCV-related stigma, including the impacts of stage of HCV treatment (i.e., spontaneously-cleared; diagnosed, untreated; previously treated, not cured; currently being treated; treated, cured) and coinfection with human immunodeficiency virus (HIV), remain unknown. To address these gaps, we conducted a cross-sectional study among patients with a history of HCV infection (n=270) at outpatient clinics in Philadelphia from July 2018 – May 2019. We evaluated stigma using the validated HCV Stigma Scale, adapted from the Berger HIV Stigma Scale. Associations among HCV-related stigma and hypothesized demographic, behavioral, and clinical risk factors were evaluated by multivariable linear regression. Most participants (95.5%) experienced HCV-related stigma. Mean stigma scores did not differ significantly between HCV-monoinfected and HIV/HCV-coinfected participants (P=0.574). However, we observed significant interactions between HIV status and multiple determinants; therefore, we stratified analyses by HIV status. Among HIV/HCV-coinfected participants, previous HCV treatment without cure, female gender, Hispanic/Latino ethnicity, and some college education were significantly associated with higher HCV-stigma scores. An annual income of $10,000-$40,000 was associated with significantly lower stigma scores. No significant associations were observed among HCV-monoinfected participants. We found that most participants experienced stigma associated with HCV diagnosis. While stigma scores were similar between HCV-monoinfected and HIV/HCV-coinfected participants, the determinants associated with HCV stigma differed by HIV status. Understanding how experiences of stigma differs between HCV-monoinfected and HIV/HCV-coinfected patients may aid in the development of targeted interventions to address the HCV epidemic.
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影响因子：
3.2
作者：
Lekas HM;Siegel K;Leider J
通讯作者：
Leider J
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影响因子：
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作者：
Loutfy MR;Logie CH;Zhang Y;Blitz SL;Margolese SL;Tharao WE;Rourke SB;Rueda S;Raboud JM
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Raboud JM
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Gamarel, Kristi E.
影响因子：
12.6
作者：
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通讯作者：
Kostman, Jay R.
影响因子：
3.7
作者：
Estes, Larissa J.;Lloyd, Linda E.;Glick, Nancy
通讯作者：
Glick, Nancy