| Objective The aim of the present study is to understand the occurrence of medical discrimination against person living with HIV/AIDS(PLWHA) in Guangdong province, to summarize the main challenges and explore the reasons in depth, and provide relevant policy recommendations for addressing medical discrimination against PLWHA.Methods Qualitative and quantitative research methods were used to understand the occurrence of discrimination among PLWHA during their medical treatment. By focusing on the investigation of PLWHA in two AIDS designated hospital outpatient in Guangdong Province (Guangzhou No.8People’s Hospital and Shenzhen Third People’s Hospital) with home-made questionnaire face to face. Use convenient sampling method to select doctors and nurses in six hospitals in Guangdong Province to investigate their occupational exposure of HIV, and their experiences and views of treatment or care PLWHA. Data were entered into a computer database using Epidata3.1software. Using SPSS13.0statistical software applications descriptive analysis,t test,χtest, analysis of variance or Wilcoxon rank sum test, the General Linear Model(GLM) and Logistic regression analysis for data analysis.Results1.35.00%(155/443) PLWHA had suffered discrimination from the medical staff, the types of differential treatment (29.38%) and refuse treatment (24.51%) are most common. Medical discrimination occurs in non-designated hospitals, and more exist in the diagnosis and treatment of occupational exposure aspects(surgery, interventional procedures, etc.). Female and be in clinical are more vulnerable to medical discrimination.2.30.70%(136/443) of PLWHA should reduce the hospital times because of HIV infection cases, and only one-third of PLWHA will take the initiative to inform the doctor of their infection. The main difficulty in the presence of PLWHA in the medical process are:the small number of designated hospitals (30.20%), high medical costs (17.29%), non-designated hospitals for medical treatment is rejected (11.93%).3.90.74%(402/443) of the respondents with anxiety symptoms,86.91%(385/443) of the respondents presence of depressive symptoms (scores≥8points). Comparison with the norm, in the objective support, subjective support, utilization of support and total social support aspect, PLWHA significantly lower than that of the normal. The scores of quality of life scale among PLWHA is between19.97and68.72, including the lowest score on the exposure of concern (19.97±23.04). Urban household registration,working, in asymptomatic infection, in therapy, good social support, and low depression scores of those infected, their quality of life is better than the comparison group.4. The mean score of HIV occupation protection knowledge among medical staff was (63.69±17.14),64.42%of the medical staff scored above60. Recently one week and one month, respectively7.32%(50/683) and9.96%(68/683) of medical staff in medical sharp spines or injury. Last week, the medical staff exposed skin, damaged skin and mucous membrane exposure to blood or blood body fluid respectively36.75%(251/683),13.03%(89/683) and9.96%(68/683).5. In the case of medical discrimination against PLWHA exists:17.42%(119/683) of people think that the hospital is entitled to refuse to provide medical services to PLWHA.67.64%(462/683) of the medical staff believe that hospital have the right to suspect HIV antibody testing. Leaked infection, differential treatment and recommended referral phenomenon also exists, and the ratio is6.73%(46/683),19.03%(130/683) and23.13%(158/683), respectively.76.43%(532/683) of the medical staff worrying about their occupational exposure to infected with HIV. Reluctance/absolutely do not want to provide general medical service or occupational exposure treatment services for PLWHA respectively, were10.25%(70/683) and15.23%(104/683). The lack of risk protection mechanisms and fear of exposure infected with HIV is the main reason. The medical staff believe that clarify the duties of the medical institutions and strengthen publicity and education are the key to solve this problem. ConclusionsThis study reveals that medical discrimination exists frequently against PLWHA, particularly in gender-base and be in clinical period. The healthcare settings of surgery, gynecology and reproductive are not optmistics, and self-discrimination among PLWHA induce themselves to reduce of the frequency of medical visits and conceal infection. The knowledge of HIV occupational protection among medical staff is in general level, occupational exposure should not be ignored; medical discrimination against PLWHA is more common, and a small part of the medical staff too fear of infection to provide PLWHA services. The lack of protection mechanism, protective cognition and vocational skills training and the fear of infection is a major cause of medical discrimination. |
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