The relationship between HIV testing, stigma, and health service usage
The relationship between HIV testing, stigma, and health service usage
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DOI：
10.1080/09540120903193666
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发表时间：
2010-01-01
影响因子：
1.7
通讯作者：
Bendavid, Eran
中科院分区：
文献类型：
--
作者：
Young, Sean D.;Bendavid, Eran
我们探讨艾滋病毒耻辱是否与试图隐瞒检测兴趣有关。我们在 1993 年至 1997 年的一项全国调查中对 86,899 名门诊患者进行了调查，并将 HIV 检测与四种非污名化检测进行了比较：肺活量测定、过敏检测、乳房 X 光检查和结肠镜检查。我们探讨了与接受对照服务的人相比，进行 HIV 检测的人是否列出了与所进行的检测不太相关的就诊原因 (RFV)、将他们对检测更频繁的兴趣列为非主要 RFV，以及是否接受了更多与检测无关的服务。共有 48.7% 的 HIV 检测者将与检测无关的原因列为主要 RFV（肺活量测定：8.9%；过敏测试：29.3%），而 69.9% 的要求检测的人将 HIV 检测作为次要 RFV（肺量测定：52%；过敏测试：0%）。根据七项服务的指数，接受艾滋病毒检测的人比未检测者（M = 0.95）接受了更多的服务（M = 1.83 额外服务）。我们没有发现肺活量测定、过敏测试、结肠镜检查或乳房X光检查之间存在这种关联。我们对这些结果的解释是，耻辱可能与行为相关，人们可能试图通过寻求艾滋病毒检测的心理掩护来避免艾滋病毒耻辱。据我们所知，这是第一项尝试使用卫生服务使用情况的观察数据来评估耻辱感以及人们应对艾滋病毒检测耻辱感的尝试的研究。
We explore whether HIV stigma is associated with seeking to conceal testing interest. We examine 86,899 outpatient visits in a 1993-1997 national survey and compare HIV testing to four non-stigmatized tests: spirometry, allergy testing, mammography, and colonoscopy. We explore whether people testing for HIV, compared to people receiving control services, listed reasons for visit (RFV) less related to the test performed, listed their interest in testing more frequently as a non-primary RFV, and received more services unrelated to testing. A total of 48.7% of people tested for HIV listed a reason unrelated to testing as their primary RFV (spirometry: 8.9%; allergy testing: 29.3%), and 69.9% of people asking to test requested HIV testing as a secondary RFV (spirometry: 52%; allergy testing: 0%). People who tested for HIV received more services (M = 1.83 additional services) than non-testers (M = 0.95) on an index of seven services. We did not find this association for spirometry, allergy testing, colonoscopy, or mammography. We interpret these results to indicate that stigma may have behavioral correlates and that people may attempt to avoid HIV stigma by seeking a psychological cover for HIV testing. To our knowledge, this is the first study to attempt to use observational data on health service usage for assessing stigma and people's attempts to deal with HIV testing stigma.