| Objectives:The use of anti-retroviral therapy had increased the life expectancy of people living with HIV/AIDS(PLWHA),but also increased the number of people living with HIV/AIDS.Thus increasing the quality of life of PLWHA has become an important theme for AIDS intervention.AIDS-related discrimination is the most common and serious social problem faced by PLWHA population.Stigma may lead to depression,risk sexual behavior and low medication compliance,as well as reduced interpersonal communication.Stigma can be divided into enacted stigma and perceived stigma,and perceived stigma have more serious effect than enacted stigma.Social capital as an invisible personal resource helps to ease the side effects of perceived stigma,but the effect of perceived stigma on social capital is not yet clear.Some scholars have proposed to explore the role of perceived stigma on social capital from three aspects:perceived community stigma,anticipation stigma and internalization stigma,based on the theory system of perceived stigma.Therefore,this study aims to understand the relationship between perceived stigma and social capital,and on this basis to explore the mechanism of perceived stigma influence social capital,the result can provide theoretical support and practical basis for AIDS stigma and social capital intervention.Methods:Using convenient sampling method,we carried out a questionnaire survey at Wuhan Medical Center.A total of 552 PLWHA patients were included,including 520 valid questionnaires.The effective rate of questionnaires was 94.2%.This survey included three aspects:population sociology,social capital,and perceived stigma.Data analysis was performed with SPSS 19.0 and Mplus7.0.Descriptive analysis,univariate analysis,correlation analysis,multiple regression analysis and mediator effect analysis were performed with SPSS 19.0,and path analysis was performed with Mplus7.0.Results:(1)Social-demographic characteristics:the majority of the participates(93.66%)were male,36.73%of the participated aged 35 years old or more.More than half of the sample(57.69%)were educated for college and above.Almost two-thirds of the of the respondents is employed,and 8.73%of them are students.More than half of the respondents were homosexual(50.38%).(2)Stigma and social capital status:The mean score of internalization stigma,perceived community stigma,and anticipation stigma among PLWHA population were 15.15,16.42 and 30.07,respectively.The mean score of the social capital scale of the respondents were 22.83 ± 5.738.(3)The influencing factors of social capital:Univariate analysis shows that gender(t=14.442,P<0.001),hukou(t=4.145,P=0.042),educational level(F=15.202,P<0.001),and monthly disposable funds(F=12.610,P<0.001)are related with social capital.There is a significant negative correlation between social capital and internalization stigma,perceived community stigma and anticipation stigma,and the correlation coefficients are-0.305,-0.256 and-0.309 respectively.Multiple linear regression analysis shows that sociological characteristics such as educational level and monthly disposable funds were related with social capital,internalized stigma(B=-0.160,95%CI-0.273?-0.047)and anticipation stigma(B =-0.105,95%CI-0.180?-0.030)were significant associated with social capital,while perceived community stigma was not statistically associated with social capital(B =-0.086,95%CI-0.235?0.063).(4)Mediation analysis of perceived discriminant effects of social capital:Mediation analysis shows that internalization stigma and anticipation stigma play part mediation roles in the relationship between perceived community stigma and social capital;anticipation stigma play a part mediation effect in the process of internalizing stigma influencing social capital.(5)Path analysis of perceived stigma impact social capital:Path analysis shows that perceived community stigma has no direct impact on social capital,but can influence social capital through internalization stigma and anticipation stigma,and internalization of stigma can affect social capital through anticipation stigma.(6)Social capital was positive associated with self-reported health status(t=0.243,P<0.001),adherence(r=0.134,P=0.003),and disclosure status(r=0.117,P=0.008).Conclusion:This paper draws the following conclusions:(1)PLWHA populations in China had high level of perceived stigma and low level of social capital;(2)Social capital was benefit for self-reported health,adherence and disclosure status.(3)Social capital among PLWHA in China was related with educational level,monthly disposable funds;(4)There are complex mechanisms of perceived stigma impact social capital:perceived community stigma impact social capital through internalization stigma and anticipation stigma,while internalization stigma impact social capital through anticipation stigma. |
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