江苏省助产机构医务人员艾滋病歧视态度现状调查和影响因素分析

摘要/Abstract

摘要： 目的调查江苏省助产机构艾滋病歧视态度现状,研究其影响因素,为消除艾滋病耻辱和歧视,营造零歧视就医氛围提供依据。方法于2023年5—6月,采用方便抽样方法抽取江苏省内助产机构医务人员,在中文版Zelaya艾滋病歧视量表的基础上借鉴中文版医务人员污名化歧视量表测量医务人员对人类免疫缺陷病毒感染者/艾滋病患者（people living with HIV/AIDS,PLWHA）母婴阻断相关的歧视态度现状。结果共收集16 008份问卷,其中15 490份有效问卷。调查显示,医务人员目前在担心感染疾病方面呈现出较严重的歧视,得分为（2.70±0.80）分,其次是就医和社会歧视行为,得分为（2.33±0.57）分,在对医疗机构的政策和环境支持中表现出较好态度,得分为（2.03±0.55）分。多因素分析显示,男性、年龄<30岁的医务人员、文化程度高、城市户籍、<5年工龄的人、低职业暴露、了解防治条例和行动计划与参加过医院培训医务人员的歧视程度较低（均P<0.05）。结论江苏省助产机构医务人员存在一定的艾滋病歧视,其中,医务人员存在态度消极和歧视情况,主要原因在于对艾滋病传播和感染的恐惧与误解。对医务人员分类和有针对性地进行反歧视健康教育,让医务人员学习《艾滋病防治条例》《预防艾滋病、梅毒和乙型肝炎母婴传播工作规范（2020）》和《消除艾滋病、梅毒和乙肝母婴传播行动计划（2022—2025）》,可以有效改善歧视现状。

关键词: 艾滋病歧视, 医务人员, Zelaya艾滋病歧视量表, 艾滋病防治, 助产机构

Abstract: Objective To investigate the status quo of acquired immunodeficiency syndrome（AIDS） discrimination attitude in midwives in Jiangsu Province,and study its influencing factors,so as to provide a basis for eliminating stigma and discrimination against AIDS and creating a zero discrimination medical atmosphere. Methods From May to June 2023,medical staff in midwifery institutions in Jiangsu Province were selected by convenient sampling method. Based on Chinese version of Zelaya AIDS discrimination scale,the Chinese version of the stigma discrimination scale for medical staff was used for reference to measure the status quo of medical staff's discriminatory attitude towards PLWHA mother infant interruption. Results A total of 16 008 questionnaires were collected,of which 15 490 were valid. The survey showed that medical personnel currently exhibit severe discrimination in worrying about infectious diseases,with a score of（2.70±0.80）points,followed by seeking medical treatment and social discriminatory behavior,with a score of（2.33±0.57）points. They showed a good attitude towards policy and environmental support for medical institutions,with a score of（2.03±0.55）points. Multivariate analysis showed that male,medical staff under 30 years of age,high education level,urban registered residence,people with less than 5 years of service,low occupational exposure,knowledge of prevention and control regulations and action plans,and medical staff who had participated in hospital training had significantly lower discrimination（all P<0.05）. Conclusion There is a certain degree of AIDS discrimination among medical staff in midwifery institutions in Jiangsu Province. Among them,medical workers have negative attitudes and discrimination. The main reason is that they fear and misunderstand the spread and infection of AIDS. Classified and targeted anti-discrimination health education for medical personnel can effectively improve the status of discrimination by letting them know the "Regulations on the Prevention and Control of AIDS","The Norms for the Prevention of Mother to Child Transmission of AIDS,Syphilis and hepatitis B（2020） ","Action Plan for the Elimination of Mother to Child Transmission of AIDS,Syphilis and hepatitis B（2022-2025） ".

Key words: AIDS discrimination, Medical staff, Zelaya AIDS discrimination scale, AIDS prevention and control, Midwifery institutions

中图分类号:

R192

蔡金怡, 陈瑶, 李琳, 罗璨. 江苏省助产机构医务人员艾滋病歧视态度现状调查和影响因素分析. [J]职业与健康, 2024, 40(19): 2668-2673.

CAI Jinyi, CHEN Yao, LI Lin, LUO Can. Investigation on status quo of AIDS discriminatory attitudes and analysis of influencing factors among medical staff in midwifery institutions in Jiangsu Province. [J]OCCUPATION AND HEALTH, 2024, 40(19): 2668-2673.

参考文献

[1] Centers for Disease Control and Prevention.What is HIV stigma?[EB/OL].(2021-06-01)[2023-11-29].https://www.cdc.gov/hiv/basics/hiv-stigma/index.html.
[2] DONG X,YANG J,PENG L,et al.HIV-related stigma and discrimination amongst healthcare providers in Guangzhou,China[J/OL].BMC Public Helth,2018,18(1):738.
[3] 王爱玲,孙贺,王前,等.中国消除艾滋病梅毒和乙肝母婴传播的挑战与展望[J].中国艾滋病性病,2023,29(8):845-847.
[4] 中华人民共和国中央人民政府.艾滋病防治条例[EB/OL].(2006-01-29)[2024-01-18].https://www.gov.cn/flfg/2006-02/12/content_186324.htm.
[5] 中华人民共和国国家卫生健康委员会.预防艾滋病、梅毒和乙肝母婴传播工作规范(2020)[EB/OL].(2020-11-12)[2024-01-18].http://www. nhc.gov.cn/fys/s3581/202011/fc7b46b2b48b45a69bd390ae3a62d065.shtml.
[6] 中华人民共和国国家卫生健康委员会.消除艾滋病、梅毒和乙肝母婴传播行动计划(2022—2025年)[EB/OL].(2022-12-05)[2024-01-18]. http://www.nhc.gov.cn/fys/s3581/202212/afe6bc9626be45a0b25bee93f01fef10.shtml.
[7] 邢海燕,温多红,陈三妹,等.中文版Zelaya艾滋病歧视量表的信度和效度[J].中华护理杂志,2012,47(12):1096-1098.
[8] NYBLADE L.Measuing HIV stigma and discrminiation among health facility staff[EB/OL].(2013-04-05)[2023-11-29].https://www.healthpolicyproject.com/index.cfm?ID=publications&get=pubID&pubID=49.
[9] TURAN J M,NYBLADE L.HIV-related stigma as a barrier to achievement of global PMTCT and maternal health goals:A review of the evidence[J].AIDS Behav,2013,17(7),2528-2539.
[10] MAHAJAN A P,SAYLES J N,PATEL V A,et al.Stigma in the HIV/AIDS epidemic:A review of the literature and recommendations for the way forward[J].AIDS,2008,22(Suppl 2):S67-S79.
[11] 王临虹,方利文,龚双燕,等.感染HIV的孕产妇预防艾滋病母婴传播服务需求与障碍分析[J].中国艾滋病性病,2006,12(1):10-15.
[12] 陆蓉,李静,游晶,等.医疗机构中艾滋病歧视的研究进展[J].职业与健康,2022,38(2):279-283.
[13] 王虹,林聃,陈银炜,等.浙江省助产机构医务人员艾滋病母婴传播知识知晓现状与歧视态度研究[J].中国妇幼卫生杂志,2021,12(6):5-9.
[14] 孙朝霞,杨谦,赵利.医务人员对HIV/AIDS病人歧视态度的研究[J].中国性科学,2019,28(10):153-156.
[15] 李洪福,王华丽.医务人员艾滋病防治知识和歧视状况及其影响因素分析[J].预防医学论坛,2023,29(10):775-781.
[16] VORASANE S,JIMBA M,KIKUCHI K,et al.An investigation of stigmatizing attitudes towards people living with HIV/AIDS by doctors and nurses in Vientiane,Lao PDR[J].BMC Health Serv Res,2017, 17(1):125.
[17] 陆蓉,李静,李佳霜,等.云南省医务工作者艾滋病歧视的现况调查[J].卫生软科学,2022,36(7):76-81.
[18] 俞素芬,沈云峰,洪奕.某社区医务人员艾滋病相关知识及歧视态度调查[J].上海预防医学,2015,27(2):79-80.
[19] CHAN Y C,BINTI MAWARDI M,ISMAIL DAUD A H.Stigmatizing attitudes toward people living with HIV/AIDS(PLWHA) among primary health care providers in kinta district,perak[J].Malays Fam Physician,2021,16(1):31-38.
[20] 刘杰伟,越朝斌,徐珮琦,等.广州市白云区医护人员艾滋病歧视现况调查[J].广州医药,2023,54(4):76-82.
[21] 曹越,黄笛,刘小平,等.中国医务人员艾滋病污名现状meta分析[J].中国公共卫生,2018,34(8):1182-1186.
[22] LAU J T,TSUI H Y,CHAN K.Reducing discriminatory attitudes toward people living with HIV/AIDS(PLWHA) in Ho-ng Kong:An intervention study using an integrated knowledge-based PLWHA participation and cognitive approach[J].AIDS Care,2005,17(1):85-101.
[23] 吴大东,陈思齐,周洁,等.深圳市助产机构医务人员艾滋病歧视现状及影响因素分析[J].中国艾滋病性病,2022,28(10):1172-1177.
[24] 杨柽,董永海,万海清,等.南昌市三家医疗机构医务人员艾滋病歧视调查及影响因素分析[J].现代预防医学,2018,45(17):3201-3206,3211.
[25] 张霄艳,王静.公立医院医务人员艾滋病歧视情况及影响因素[J].邵阳学院学报(自然科学版),2023,20(1):97-104.
[26] 郭建梅,田甜,罗桂英,等.医务人员艾滋病歧视态度相关因素结构方程模型分析[J].中国艾滋病性病,2017,23(2):162-164.
[27] 龚琪,胡天天,方鹏骞.湖北省医务人员艾滋病歧视现状分析[J].医学与社会,2016,29(10):85-88.
[28] NYBLADE L,ADDO N A,ATUAHENE K,et al.Results from a difference-in-differences evaluation of health facility HIV and key population stigma-reduction interventions in Ghana[J].Int AIDS Soc,2020, 23(4):e25483.
[29] 栾兴玉,吴音,程彬,等.重庆市某三甲医院医务人员消除艾滋病歧视调查及干预[J].实用预防医学,2021,19(6):942-944.