深圳市医疗机构中HIV相关羞辱与歧视的现况研究

Stigma and discrimination towards HIV among healthcare workers in Shenzhen City

目的了解深圳市宝安区医疗机构中医务工作者艾滋病(HIV)相关的羞辱和歧视(S&D)现况,为制定相关政策提供依据。方法在2019年10月至2020年1月期间,采用标准化测量工具,对18家公立和私立医院的1235名医务人员进行横断面调查。收集人口学资料、HIV感染担忧、医疗机构中存在的羞辱与歧视现象或政策等数据信息。结果医务人员HIV感染担忧发生率为73.1%(95%CI:70.5%~75.6%);包扎伤口65.0%(95%CI:62.2%~67.8%)和测体温82.5%(95%CI:78.8%~83.4%)时最为担忧;与男性相比,女性更容易产生担忧情绪;护士比医生更担忧HIV职业感染;接受培训是防止因接触HIV患者而产生感染焦虑的保护因素。21.3%(95%CI:18.9%~23.6%)的受访者承认会避免与艾滋病感染者(people living with HIV,PLWH)有身体接触;53.0%(95%CI:50.1%~55.9%)的受访者在与PLWH接触时会选择戴双层手套,有75.4%(95%CI:72.9%~77.9%)的受访者认为艾滋病感染者应该到指定的传染病专科医院就诊。60.7%(95%CI:72.9%~77.9%)的医务人员认为,HIV育龄妇女不应该再生育。42.7%(95%CI:39.8%~45.6%)的受访者报告自己所在医疗机构中没有或不知道关于严禁歧视PLWH的文件或制度。结论在医疗卫生机构中,存在针对PLWH羞辱与歧视的现象。保障PLWH获得平等医疗卫生服务的权利,医疗机构中减少HIV相关羞辱与歧视的干预工作必要且紧迫。

Objective To understand the current status of stigma and discrimination related to AIDS(HIV)among healthcare workers in medical institutions in Bao′an District of Shenzhen,and to provide a basis for formulating relevant policies.Methods From October 2019 to January 2020,a cross-sectional survey was conducted using standardized measurement toolsamong 1235 medical staffs in 18 public and private hospitals.Information of demographic information,HIV infection concerns,stigma and discrimination in medical institutions,or policies were collected.Results The incidence of HIV infection worry among medical staffs was 73.1%(95%CI:70.5%-75.6%),65.0%(95%CI:62.2%-67.8%)of them worried about bandage wounds and 82.5%(95%CI:78.8%-83.4%)for temperature measurement.Compared with men,women were more worried.Nurses were more worried about occupational HIV infection than doctors.Training was protective factor to prevent infection anxiety caused by contact with HIV patients.21.3%(95%CI:18.9%-23.6%)of the respondents admitted that they would avoid physical contact with people living with HIV(PLWH).When contacting PLWH,53.0%(95%CI:50.1-55.9)of the respondents would choose to wear double gloves.75.4%(95%CI:72.9%-77.9%)of the interviewees believed that PLWH should go to a designated infectious disease hospital for treatment.60.7%(95%CI:72.9%-77.9%)of medical staff believed that women of childbearing age with HIV should not give birth.42.7%(95%CI:39.8%-45.6%)of the respondents reported that their medical institutions did not have or did not know about the prohibition of discrimination against PLWH documents or systems.Conclusion In medical institutions,there was stigma and discrimination against PLWH.To protect PLWH′s right to equal medical care services,interventions to reduce HIV-related stigma and discrimination in medical institutions are necessary and urgent.