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目的:在云南省德宏州调查边疆地区艾滋病(HIV)感染者在“四免一关怀”政策实施背景下自身感受的耻辱情况及相关因素。方法:选取德宏州傣族景颇族自治州≥18岁的HIV感染者300名,采用简化耻辱量表(BHSS)调查研究对象自身感受耻辱的情况及不同人口学特征研究对象的BHSS评分差异(BHSS包括感染者感受到的排斥、负面自我印象、对身份暴露的担忧和身份暴露的伤害4个维度。总分=0分为不存在艾滋病耻辱感),采用多重线性回归分析筛选耻辱感的相关因素。结果:BHSS平均分为(7.0±4.1),其中身份暴露的伤害维度得分最高(2.4±1.8);97.3%的调查对象存在艾滋病耻辱感。无业的感染者BHSS得分高于农民及其他职业者,非艾滋病病人HIV感染者BHSS得分高于艾滋病人HIV感染者,亲人不知情的感染者BHSS得分高于亲人知情的感染者,未接受过生活救助的感染者BHSS得分高于接受生活救助的感染者(均P<0.05)。多重线性回归显示,职业、亲人知情情况、生活救助、病情分类与BHSS得分负向关联(β=-0.32、-0.14、-0.16、-0.15,均P<0.05)。结论:在德宏州这一边疆地区,艾滋病感染者的耻辱感较高,且无业者、非艾滋病病人HIV感染者、亲人不知情者、未接受过生活救助者耻辱感更高。
Objective: To investigate the stigma and related factors of HIV infection in frontier areas in Dehong Prefecture of Yunnan Province under the “Four Frees and One Care” policy implementation. Methods: 300 HIV-infected persons aged 18 or older in Dehong Prefecture Jingpo Autonomous Prefecture of Dehong Prefecture were enrolled in this study. The self-stigma of the subjects was investigated using the simplified humiliation scale (BHSS) and the differences in BHSS scores among subjects with different demographic characteristics (BHSS included The four dimensions of exclusion, negative self-perception, identity-exposed and identity-exposed injury, total score = 0 divided into no sense of stigma of HIV / AIDS, and multiple linear regression analysis to screen for factors related to stigma. Results: The mean score of BHSS was (7.0 ± 4.1), with the highest scores of injury dimensions of identity exposure (2.4 ± 1.8); 97.3% of the respondents had a sense of stigma of AIDS. The BHSS score of unemployed patients was higher than that of peasants and other professionals. The scores of BHSS in HIV-infected non-AIDS patients were higher than those in HIV-infected patients. The scores of BHSS in uninformed patients were higher than those in HIV-infected individuals and did not receive life The BHSS score of rescue recipients was higher than that of those who received life support (all P <0.05). Multiple linear regression showed that there was a negative correlation between occupational and relatives’ information, life-aid and disease classification and BHSS score (β = -0.32, -0.14, -0.16, -0.15, all P <0.05). Conclusion: In the border region of Dehong prefecture, people with HIV / AIDS have a high sense of disgrace and there is a higher sense of disgrace to those who are unemployed, those who are HIV-positive with non-AIDS, those who are not known by their loved ones, and those who have not received any help.