艾滋病高发地三个人群主观幸福感的调查研究

Study on Subjective well being among people living in AIDS epidemic area

目的了解艾滋病的流行和目前各种艾滋病关怀政策与措施对艾滋病高发地不同人群主观幸福感的影响。方法采用总体幸福感量表(GWB)测定不同人群主观幸福感,比较并进行影响因素分析。结果调查PLWHAS194例,有PLWHAS存在乡镇的普通村民246名,一般普通村民213名。其中,PLWHAS存在的乡镇普通村民的主观幸福感最高,其次为普通村民,乡镇PLWHAS位居第三。对生活的满足和兴趣,乡镇PLWHAS高于其他两个人群,在对情感和行为的控制上,乡镇PLWHAS高于一般普通村民,其余各因子的得分PLWHAS均低于PLWHAS存在的乡镇普通村民和普通村民。PLWHAS存在的乡镇普通村民对健康的担心低于一般普通村民,而对情感和行为的控制,高于一般普通村民。多元回归分析结果提示健康状况、社会歧视、社交范围、身份公开、本村亲戚数、性别影响PLWHAS的主观幸福感;健康状况、本村疫情影响PLWHAS存在的乡镇普通村民的主观幸福感。结论艾滋病直接影响与其有关的各人群主观幸福感、社会支持、控制疫情,消除人群对艾滋病的恐惧和担心以及加强社会关怀力度是提升艾滋病高发地各类人群主观幸福感的工作重点。

Objective To explore the subjective sensation of well-being and its related factors among peoples living in AIDS epidemic area. Methods General well-being scale （GWB） was used to evaluate the targeted population and multiple regression was performed to identify factors related. Results The investigated subjects included 194 people living with HIV/AIDS （PLWHAS） in epidemic villages, 246 healthy residents living in AIDS epidemic villages and another 213 living in non-AIDS epidemic villages. Healthy rural residents living in AIDS epidemic area reported highest score of subjective well-being, followed by healthy residents living in non-AIDS epidemic villages, PLWHAS in epidemic village （P〈0.05）. As for scores of GWB domains, “satisfaction with living” （domain S） was higher in PLWHAS, “emotional and behavioral” （domain O） was higher among PLWHAS than residents living in non-AIDS epidemic village. The levels of the other domains appeared lower among PLWHAS compared with the other two groups. “ Health anxiety”（domain H）in healthy rural, residents living in AIDS epidemic area was lower than in non-AIDS epidemic village, but “emotional and behavioral” （domain O）was higher（P〈0.05）. Disease-specific factors associated with lowered scores of sensation of well-being among PLWHAS were sbown to be poor health status, disclosed infection, long duration of AIDS and intensively perceived social stigma （P〈0.05 by Chi-square test）.Multivariate regression showed that the well-being among PLWHAS was affected with health status, social stigma, range of social interactions, disclosed infection, number of native relatives and gender, and that of heahhy residents was affected with health status and local epidemics （all P〈0.05）. Conclusion AIDS epidemic poses an impact on subjective well being among local individuals. Social support, disease control, fight against social fear of AIDS and enhanced community care of HIV/ AIDS remain the focus for improving sensation of well-being among people living in epidemic areas.