Experiences of HIV-Related Stigma Among Young Men Who Have Sex with Men
Experiences of HIV-Related Stigma Among Young Men Who Have Sex with Men
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DOI：
10.1089/apc.2008.0256
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发表时间：
2009-05-01
影响因子：
4.9
通讯作者：
Garofalo, Robert
中科院分区：
文献类型：
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作者：
Dowshen, Nadia;Binns, Helen J.;Garofalo, Robert
在许多社区，男男性行为者（MSM）是越来越多的新艾滋病毒感染者。许多人仍然持有可能导致歧视艾滋病毒抗体阳性者的信念。艾滋病毒耻辱与负面的健康和心理社会后果有关，并可能给这一边缘化群体带来更大的挑战。本研究描述了艾滋病毒阳性的年轻男男性接触者所经历的耻辱，探讨了其与心理社会措施的关系，并检验了耻辱分数将在不到1年前诊断的人高于1年以上的假设。从2004年8月至2005年9月，年轻的男男性行为者完成了一份问卷，包括人口统计信息和心理社会措施。关联的描述性和双变量分析被用来解释数据从总的耻辱量表和四个分量表：个性化的耻辱（PS），公众态度（PA），消极的自我形象（NSI），和披露的关注（DC）。通过标准化每个分量表进行直接比较来计算指数评分。42名参与者平均年龄为21.3岁; 45%为黑人，24%为西班牙裔，26%为白色; 14%为变性人; 50%为确诊HIV阳性不到1年。参与者报告了所有领域的艾滋病毒相关耻辱，平均指数子量表得分：PS 0.57，PA 0.61，NSI 0.63，DC 0.75，表明与其他形式的艾滋病毒相关耻辱相比，披露问题普遍存在。污名得分与抑郁、社会支持、自尊和浪漫孤独相关。对于不到1年前诊断的患者和超过1年前诊断的患者，污名评分没有差异。提供者在照顾艾滋病毒阳性的年轻男男性行为者时，应解决与艾滋病毒有关的耻辱问题，特别是在疾病的整个过程中，将其作为影响健康结果和心理社会功能的一个因素。
Young men who have sex with men (MSM) represent an increasing number of new HIV infections in many communities. Many individuals still hold beliefs that may lead to discrimination against HIV-positive individuals. HIV stigma is associated with negative health and psychosocial outcomes and may lead to greater challenges for this marginalized population. This study describes stigma experienced by HIV-positive young MSM, explores its relationship to psychosocial measures, and tests the hypothesis that stigma scores will be higher in those diagnosed less than 1 year ago versus more than 1 year. From August 2004 to September 2005 young MSM completed a questionnaire including demographic information and psychosocial measures. Descriptive and bivariate analyses of association were used to interpret data from the total stigma scale and four subscales: personalized stigma (PS), public attitudes (PA), negative self-image (NSI), and disclosure concerns (DC). Index scores were calculated by standardizing each subscale for direct comparisons. The 42 participants were: mean 21.3 years; 45% black, 24% Hispanic, 26% white; 14% transgender; and 50% diagnosed HIV-positive less than 1 year. Participants reported HIV- related stigma across all domains with mean index subscale scores: PS 0.57, PA 0.61, NSI 0.63, DC 0.75 indicating that disclosure concerns were prevalent in comparison to other forms of HIV- related stigma. Stigma scores correlated with depression, social support, self-esteem, and romantic loneliness. Stigma scores did not differ for those diagnosed less than 1 year ago versus more than 1 year ago. Providers should address HIV- related stigma concerns, particularly disclosure, throughout the trajectory of the illness when caring for HIV- positive young MSM as a factor affecting health outcomes and psychosocial functioning.