HIV阳性感染者知晓HIV感染状况前后心理变化及其对不安全性行为的影响

Psychological change and its influence on unsafe sexual behavior of patients before and after being informed of HIV infection

目的比较分析HIV阳性感染者在知晓HIV感染状况前后的不安全性行为和心理变化,为防制HIV性传播提供科学依据。方法采用整群随机抽样的方法,对昆明市190名HIV感染者被告知HIV感染时和告知后6个月的性行为、心理反应回顾性调查,采用配对McNemar检验和多因素条件logistic回归分析进行统计学处理。结果知晓自己HIV血清学检测阳性结果后6个月和知晓时相比,因为感染HIV而产生的情绪低落、绝望心理、否认感染的人数比例分别由56.84%、34.21%、20.00%下降到18.95%、9.47%、4.74%,接受感染现实的由38.95%上升到78.42%;想报复社会的由4.21%下降到1.58%。担心受到歧视、家庭破裂、活不了多久的分别由61.58%、48.95%、37.37%下降到50.00%、28.42%、21.58%。愿意将自己个人状况告知他人的比例由21.05%上升到54.21%。知晓感染状况前后,发生性行为的人数比例分别为53.68%、48.42%,差异无统计学意义。但是发生不安全性行为的由59.80%下降到18.47%;阴道性交每次使用安全套的比例由23.38%上升到77.92%。在首次告知6个月后,接受安全套发放服务的人数比例由35.26%上升到64.74%。结论阳性告知对感染者的心理变化的影响是复杂的,必须提高社会、家庭和HIV感染者对艾滋病的认识,减少歧视,开展针对性宣传和教育,以缓解HIV感染者的精神压力。

Objective To provide scientific evidence for HIV/AIDS prevention by comparing the psychological change and unsafe sexual behavior of patients before and after being informed of HIV infection. Methods One hundred and ninety HIV patients were randomly selected by cluster sampling method in Kunming city. A retrospective survey was conducted. McNamara test and logistic regression were used for data analysis to corn pare sexual behavior and psychological change before and after being informed of HIV infection. Results Six months after being informed of HIV infection, the percentage of patients feeling depressed, hopeless and self- denied decreased from 56.84%, 34.21%, 20.00% to 18. 95%, 9.47% and 4.74%, respectively. Meanwhile, the number of patients who accepted the fact of HIV infection increased from 38.95% to 78.42% and those who wanted to take revenge on society decreased to 1.58% from 4.21%. Also, the percentage of patients who was afraid of being abused, family breakupor not living much longer decreased from 61.58%, 48.95%, 37.37% to 50.00%, 28.42%and 21.58%, respectively. More than half of patients were willing to tell others about their infection and only 18.47% still had unsafe sex, which decreased dramatically from 59.80%. 77.92% of patients used condoms during sexual intercourse, which significantly increased from 23.38%. Conclusions Being informed of HIV infection has a complicated effect on patients psychologically. Therefore,in order to relieve the stress of HIV infected individuals, it is necessary to raise the awareness of the whole society, family as well as HIV patients, and to eliminate discrimination on patients.