Stigma Status And Its Influenceing Factors Among People Living With HIV/AIDS

BackgroundAIDS is a very high case fatality rate of chronic infectious disease.AIDS epidemic at the goble trend of the sprend has not been the fundamental control.AIDS prevention and control situation in our country is also more severe.In recent years,as government bailout,the promotion and popularization of free antiretroviral treatment,effectively slow the disease process,prolong the survival of people living with HIV/AIDS patients.But due to the particularity of disease,HIV stigma is one of the biggest challenges faced by all nations around the world among fignting against HIV/AIDS.Foreign existing research shows that HIV stigma has an important role in the spread of the AIDS epidemic.It profoundly affects the lives of individuals living with HIV/AIDS and plays an important role in the monitoring and prevention of HIV barrier.The current domestic research on HIV stigma is less.In order to effectively reduce stigma,it is urgently needed to investigate the level and influencing factores of perceived HIV stigma.These can offer theoretical basis for clinical intervention.Objective1.To describle the current status of stigma among people living with HIV/AIDS(PLWHA).2.To investigate the related factors affecting stigma in PLWHA and offer theoretical basis for clinical intervention.MethodsBy convenience sampling,patients with HIV/AIDS who prepare or have accepted antiviral treatment for PLWHA were interviewed from January to April in 2017 when they came to the second hospital of Nanjing.They were investigated with a self-designed demographic questionnaire,Social Impact Scale(SIS),General Self-Efficacy Scale(GSES),Medical Coping Modes Questionnaire(MCMQ),Word Health Organization's quality of life scale-brief form questionnaire(WHOQOL-BREF)and 10-item Cornor-Davidson Resilience Scale(CD-RISC-10).The survey results were statistically analyzed using SPSS 19.0 statistical software.Statistical description:demographics characteristics,disease related information,SIS,GSES,MCMQ,WHOQOL-BREF,CD-RISC-10.Stigma as the dependent variable and other factors as the independent variable.Multi-linear regression analysis was employed to analyze the factors influencing the PLWHA's stigma.ResultesThis investigation altogether provides questionnaire 265,the actual recovery of 263 copies,of which 248 vaild questionnaires,for an effective questionnaire returns-ratio is 93.6%.1.The general scores of SIS was(66.06±15.44)according to the survey.The four dimensions'score of Social impact scale were social rejection(23.39±6.42),financial insecurity(8.48±2.47),internalized shame(15.26±3.26),social isolation(18.93±5.10).SIS four dimension scores were higher than study abroad,in addition to financial insecurity to the dimension of the other three dimension compared with abroad there is statistical significance(P<0.05).2.Results scores of GSES with PLWHA was 24.99±7.90 which was significantly lower than the domestic norm(t = 3.539,P<3.539).Results of resilience score with PLWHA was 25.23±8.37,the results similar to those of patients with gastrointestinal cancer,compared with foreign norm,the difference was statistically significant(t=4.228,P<0.001).3.According to the survey:The general scores of WHOQOL-BREF was 85.66±16.05.The four dimensions'score of WHOQOL-BREF were Physical domain(23.23±4.81),psychological domain(20.19±4.33),social domain(9.83±2.35)and environment domain(26.31 ±5.53).WHOQOL-BREF of four dimensions scores were significantly lower than norm(P<0.001).4.Results of MCMQ score with PLWHA was 45.04±5.42.The facing,avoidance and surrender dimensions scores were(18.06±3.58),(16.83±2.71),(10.15±3.45).MCMQ of four dimensions scores were significantly lower than norm(P<0.001).5.Results of single factor analysis showed that the stigma level with PLWHA related to patient's age,marital status,educational level,occupation,income,course of HIV infection,infection and complications,clinical stage,CD4T lymphocytes count,self-efficacy,resilience,the quality of life,and coping style levels.And sex,census register seat,religious beliefs,and health care were no statistical significance(P>0.05).Analysis of multiple stepwise regressions showed that educational level,coping styles and quality of life were the influencing factors of SIS in patients with HIV.Conclusion1.Stigma is common among PLWHA which has negative effect on their life,resulting in a decline in quality of life.Stigma was related to multiple factors,especially the educational level,coping styles and quality of life.2.The lower the educational level,the higher of stigma.For the low level of the educational level in PLWHA should be given more attention.PLWHA using the surrender to deal can increase the level of stigma.