Personal contact with HIV-positive persons is associated with reduced HIV-related stigma: cross-sectional analysis of general population surveys from 26 countries in sub-Saharan Africa
Personal contact with HIV-positive persons is associated with reduced HIV-related stigma: cross-sectional analysis of general population surveys from 26 countries in sub-Saharan Africa
复制标题
DOI：
10.7448/ias.20.1.21395
复制
发表时间：
2017-01-11
影响因子：
6
通讯作者：
Tsai, Alexander C.
中科院分区：
文献类型：
--
作者：
Chan, Brian T.;Tsai, Alexander C.
简介：与艾滋病毒相关的耻辱阻碍了全世界的治疗和预防工作。非常需要采取有效的干预措施来消除与艾滋病毒相关的耻辱感。尽管“接触假说”表明与艾滋病毒感染者（PLHIV）的个人接触可能会减少普通人群的污名化态度，但缺乏支持这一假说的经验证据。我们的目的是估计撒哈拉以南非洲普通人群中与艾滋病毒感染者的个人接触与艾滋病毒相关耻辱之间的关联。方法：使用 2003 年至 2008 年间 26 个非洲国家的人口统计和健康调查以及艾滋病指标调查中包含的标准艾滋病毒相关耻辱问题来操作社会距离和预期耻辱。我们拟合了具有国家级固定效应的多变量逻辑回归模型，将社会距离指定为因变量，将个人接触指定为因变量。 PLHIV 是我们感兴趣的主要解释变量。结果：我们分析了生活在 26 个撒哈拉以南非洲国家的 206,717 名女性和 91,549 名男性的数据。我们估计，与艾滋病毒携带者的个人接触与社交距离的愿望之间存在统计学上显着的负相关关系（调整后的比值比 [AOR] = 0.80；p < 0.001；95% 置信区间 [CI]，0.73-0.88）。在敏感性分析中，使用社区层面变量与 PLHIV 进行个人接触的模型也得到了类似的结果（AOR = 0.92；p < 0.001；95% CI，0.89-0.95）。 结论：与 PLHIV 的个人接触与撒哈拉以南非洲普通人群对社交距离的渴望减少有关。应制定和测试更多的接触干预措施，以减少艾滋病毒的耻辱。
Introduction: HIV-related stigma hampers treatment and prevention efforts worldwide. Effective interventions to counter HIV-related stigma are greatly needed. Although the "contact hypothesis"suggests that personal contact with persons living with HIV (PLHIV) may reduce stigmatizing attitudes in the general population, empirical evidence in support of this hypothesis is lacking. Our aim was to estimate the association between personal contact with PLHIV and HIV-related stigma among the general population of sub-Saharan Africa.Methods: Social distance and anticipated stigma were operationalized using standard HIV-related stigma questions contained in the Demographic and Health Surveys and AIDS Indicator Surveys of 26 African countries between 2003 and 2008. We fitted multivariable logistic regression models with country-level fixed effects, specifying social distance as the dependent variable and personal contact with PLHIV as the primary explanatory variable of interest.Results: We analyzed data from 206,717 women and 91,549 men living in 26 sub-Saharan African countries. We estimated a statistically significant negative association between personal contact with PLHIV and desires for social distance (adjusted odds ratio [AOR] = 0.80; p < 0.001; 95% Confidence Interval [CI], 0.73-0.88). In a sensitivity analysis, a similar finding was obtained with a model that used a community-level variable for personal contact with PLHIV (AOR = 0.92; p < 0.001; 95% CI, 0.89-0.95).Conclusions: Personal contact with PLHIV was associated with reduced desires for social distance among the general population of sub-Saharan Africa. More contact interventions should be developed and tested to reduce the stigma of HIV.