The Investigation Of Social Support, HIV-related Discrimination/Shame And High-risk Behaviors Among People Who Living With HIV/AIDS

Background:As the increasing of the number of PLWHA(people who living with HIV/AIDS), now paying attention to the survival state of PLWHA, to know more about their high-risk behavior and to explore the relative factors, seeking to improve the quality of their lives and finding the way to prevent further spread of HIV/AIDS becomes more and more important. It is essential to carry out the research.ObjectiveTo detect the state of social support, stigma and discrimination, and HIV/AIDS related high-risk behaviors after being affirmed to be HIV positive, explore the respective influence factors of the social support,stigma and high-risk behaviors among PLWHA in Yunnan province. Meanwhile to evaluate the effect of "Four free one care"policy and provide a scientific basis for relevant policy.MethodsQuestionnaire was mainly adopted, supplemented by in-depth interview for the study. By using fixed place continuous sampling,300PLWHA who were followed-up from May15to June14of2012from Mangshi, Ruili and Longchuan county, over18years old and having been affirmed of HIV positive for more than three months, were selected for questionnaire, and all of those with HIV related high-risk behaviors after being confirmed of HIV positive were asked for in-depth interviews. The Social Support Rating Scale was adopted for evaluation of social support, and the simplified Berger HIV Stigma Scale was used for evaluation of felt stigma.Results1Three hundred effective questionnaires were taken back from the303 questionnaires distributed, the effective rate was99%; All the78patients with high-risk behavior was asked for the in-depth interview,78interview results were taken back.2The total score of social support for PLWHA (37.90±8.01) was significantly higher than the norm domestic level (34.56±3.73), t=7.219, P<0.001. Total social support not only was affected by nationality, occupation, marital status, household income, and also related to relatives knowing the HIV infection status, time of finding HIV positive, antiviral treatment and life assistance. Occupation and marital status influenced a lot. The unemployed and mateless had less social support than their corresponding people.3The stigma of respondent scored0～15points, on average is (7.04±4.12);23.7% of respondents felt serious stigma; Stigma related to nation, occupation, disease classification, relatives knowing,life rescue; Shame was relatively higher for the han nationality, unemployed, people living with HIV, those without family member knowing and those having never accepted life rescue than their respective corresponding people.4Most of PLWHA hided the status of HIV infection to the surroundings. Proportion was higher for governors, neighbour and friends, respectively36.3%、34.7%and24.0%,lower for medical workers and relatives. After be known that they had been caught HIV, PLWHA would be discriminated in higher proportion by relatives, friends and neighbour, respectively12.5%、13.6%and16.8%; There were only2PLWHA in all respondents,without anyone knows their infectious status, and22.8%(68people)of the others were discriminated by social people because of HIV.5After be confirmed of HIV positive,26.0%(78people) of the respondents having unprotected behaviors. According to Logistic analysis,the risk factors for having HIV related high-risk behavior were stigma and the marriage status,OR value for serious stigma was1.89(95%CI was1.09～3.27),OR value for the marriage status was2.99(95%CI was1.43-6.26).According to interview,we found that the occurrence of high-risk behavior related to lack of clean injector for intravenous drug users, and some female with HIV were still occupied in commercial sex behavior because of hard life.ConclusionThe life status for PLWHA in Yunnan province is worrying especially for the unemployed, and without spouse. Their social support is lower. Substantial proportion of PLWHA feel stigma for HIV, and part of them hide their infectious status because of stigma and afraid of be discriminated. Part of them had high-risk behaviors after be confirmed HIV positive, the risk factors for having HIV related high-risk behavior is stigma and marriage status.Suggest to strengthen the care for the unemployed, without spouse, and enhance the management of PLWHA, to reduce the stigma, promote positive education and the spouse informing, to prevent the second generation spread of HIV/AIDS.