AIDS stigma as an obstacle to uptake of HIV testing: evidence from a Zimbabwean national population-based survey
AIDS stigma as an obstacle to uptake of HIV testing: evidence from a Zimbabwean national population-based survey
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DOI：
10.1080/09540120903038374
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发表时间：
2010-01-01
影响因子：
1.7
通讯作者：
Mishra, Vinod
中科院分区：
文献类型：
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作者：
Sambisa, William;Curtis, Sian;Mishra, Vinod
利用2005-2006年津巴布韦人口和健康调查，我们调查了妇女(6839人)和男子(5315人)样本中艾滋病毒检测吸收的流行率，并确定了艾滋病污名对检测吸收的独立影响，特别强调了三种检测途径：自愿检测、提供检测时检测和需要检测时检测。女性自我报告艾滋病毒检测的患病率(31%)高于男性(22%)。对于女性来说，测试吸收的主要途径是接受提供测试时的测试(46%)，而对于男性来说，这是自愿测试(53%)。在Logistic回归模型中，我们发现，在所有测试途径中，女性的社会拒绝污名与吸收呈负相关，而男性则不是。关于观察到的污名，既认识艾滋病毒携带者又观察到对艾滋病毒携带者的歧视的受访者更有可能通过所有途径进行艾滋病毒检测，而那些认识艾滋病毒携带者但没有观察到耻辱的受访者更有可能自愿进行检测。对采用测试很重要的个人特征包括高教育程度、宗教、接触大众媒体和曾经使用避孕套；而从未结过婚和自我感觉到的风险是测试的障碍。旨在增加艾滋病毒检测接受率的方案战略应考虑减少对艾滋病毒/艾滋病患者的耻辱，并解决机构和结构在个人决定接受艾滋病毒检测方面的作用。
Using the 2005-2006 Zimbabwe Demographic and Health Survey, we investigated the prevalence of HIV testing uptake within a sample of women (6839) and men (5315), and identified the independent effects of AIDS stigma on testing uptake, with particular emphasis on three pathways to testing: voluntary testing, testing when offered, and testing when required. The prevalence of self-reported HIV testing was higher among women (31%) than men (22%). For women, the main pathway to testing uptake was to accept testing when it is offered (46%), whereas for men it was voluntary testing (53%). In the logistic regression models, we found that social rejection stigma was inversely associated with uptake across all pathways of testing for women, but not men. As regards observed enacted stigma, respondents who both knew someone with HIV and had observed discrimination against someone with HIV were more likely to test for HIV through all pathways, while those who knew someone with HIV but had not observed stigma were more likely to test voluntarily. Individual characteristics important to the adoption of testing included high educational attainment, religion, exposure to mass media, and ever use of condoms; while being never married and self-perceived risk were barriers to testing. Programmatic strategies aimed at increasing HIV testing uptake should consider reducing stigma toward people living with HIV/AIDS and also addressing the role of agency and structure in individual's decision to be tested for HIV.