Study On The HIV/AIDS-related Stigma And Discrimination Within MSM Community

Objective To understand the current situation of the psychological status and HIV/AIDS-related stigma and discrimination of part of populations of men who have sex with men(MSM) in Anhui Province, including the current situation of the(HIV/AIDS) self-perception stigma and discrimination of HIV-infected people and patients, the differential pattern feature and major manifestation of the HIV/AIDS-related stigma and discrimination of non-infected companions in different relationship layers on HIV-infected people and patients in the latter, and analyze the influence factors caused by MSM to provide scientific basis and clues for the development of AIDS prevention and control and intervention study on anti-discrimination of AIDS in MSM populations. Methods Survey 184 HIV-positive MSM and 202 HIV-negative MSM of Anhui Province anonymously in ways of “snowball” and convenience sampling on the basis of face-to-face questionnaire survey. Record data by means of software EpiData3.1, conduct data analysis by using SPSS 13.0, namely conduct data analysis via analysis of variance, t-test, chi-square test, correlation analysis and multiple stepwise regression analysis. Results 1.General demographic characteristics: the ages of 60% respondents are below 35; more than 50% respondents have education backgrounds of junior college and undergraduate college and above; more than 15% MSMs have the experience of marriage; the monthly incomes of about 50% respondents are less than RMB 2000 Yuan; and 65% MSMs are from cities. 2.Sexual behavior characteristics: in recent 6 months, 51.6% MSM infected persons have no sexual companions, with 68.4% MSM infected persons who insist in using condoms every time; and 71.8% HIV-uninfected MSM select 1-5 sexual companions, with 44.1% persons who use condoms every time. 3. The situation of the HIV/AIDS-related stigma and discrimination among MSM communities 3.1 The situation of the self-perception HIV/AIDS-related stigma and discrimination of HIV-infected MSMsThe total scores of the self-perception stigma and discrimination of HIV-infected MSMs is(108.05±22.95), and the scores of personalized stigma and public attitudes subscales is the highest. One-way ANONA analysis indicates that the total score of the self-perception stigma and discrimination and the score of each subscales of HIV-infected MSMs who are older and long in infection time are high; the score of personalized stigma and negative self-image subscales of HIV-infected MSMs who keep infection secrets to MSM outsiders of classmates, colleagues, etc. is high; HIV-infected MSMs who are married and are high in condom operating frequency are more afraid of disclosing infection secret; and the evaluation on the self-image of HIV-infected MSMs who are from countries and low in standard of culture and do not disclosure infection information to anyone is negative. Multiple stepwise regression analysis shows that the influence factors of the self-perception stigma and discrimination of HIV-infected MSMs mainly include age, occupation, registered permanent residence, standard of culture, HIV diagnosis time, and the condition whether infection information is informed initiatively or not and whether suicidal thoughts are generated in recent 6 months or not, depression and the level of self-esteem. 3.2 The situation of the HIV/AIDS-related stigma and discrimination of HIVuninfected MSM in different relationship layers on HIV/AIDS companionsThe scores of the stigma and discrimination of HIV-uninfected MSM on HIV/AIDS companions in different relationship layers has difference in statistics(P<0.01) and has the differential pattern feature that the discrimination degree is increased with intimacy degree, and the score of discrimination on HIV/AIDS sexual companions is higher than that of discrimination on MSM ordinary friends and general persons(P<0.01). The discrimination from the non-infected homosexual partners relationship layer is focused on the refusal and repulsion on the sexual requirements of HIV/AIDS sexual companions, while the discrimination from ordinary friends and general persons is manifested in discussion, estrangement, ridicule, etc. Multiple stepwise regression analysis indicates that the stigma and discrimination of HIV- uninfected MSMs on HIV-infected companions in different relationship layers are associated with the level of HIV/AIDS-related elementary knowledge. 4. The psychological status of MSM populationsThe total score of depression of HIV-infected MSMs is 21.96±11.31, with 47.68±11.02 for the total score of anxiety and 19.23±4.52 for the total score of self-esteem, 31% respondents had suicide ideas once, depression and anxiety are in positive correlation with stigma and discrimination as well as each subscale, and the self-esteem level is on the contrary. The total score of depression of HIV- uninfected MSMs is 17.66±22.56, with 47.38±8.26 for the total score of anxiety and 22.56±4.05 for the total score of self-esteem, and generally, the psychological status is superior to that of HIV-infected MSMs(P<0.05). Conclusion 1. The stigma and discrimination on HIV-infected MSMs prevail among MSM communities, and differential pattern feature that the discrimination degree is increased with intimacy degree is prevalent; and the influence factor affecting stigma and discrimination is HIV/AIDS-related elementary knowledge. In ordinary friends and general persons relationship layer in HIV-infected MSMs circle, discrimination is manifested in verbal abuse and social isolation, and the discrimination of homosexual sexual partners infected with HIV is focused on the refusal and repulsion on sexual requirements. 2. The self-stigma and discrimination of HIV-infected MSMs are in the medium range, the score of public attitudes subscales is the highest, the influence factors of concerning on dimension disclosure are the maximum, and the self-stigma and discrimination level of HIV-infected MSMs are related to the level of mental health; and majority of persons who have large ages, are married, are on-the-job, long in infection time and high in condom operating frequency, do not initiatively inform infection status, and have depressed, low self-esteem and suicide ideas is high. 3. The MSM populations are poor in the level of mental health status, the occurrence rate of depressed, anxious, low self-esteem and suicide ideas is higher than that of general populations; and the psychological status of HIV-infected MSMs is poor than that of HIV-uninfected MSMs and is related to the scoring of self-stigma and discrimination, and the total score of the self-stigma and discrimination of MSM infected persons who are depressed and low in self-esteem and have suicide thoughts is also high.