埃塞俄比亚北部Axum卫生机构成年人HIV阳性状况披露的决定因素:对治疗依从性的影响

Haileselasie Berhane Alema, Kebede Haile Misgina, M. Weldu
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引用次数: 5

摘要

向性伴侣、朋友或亲属披露艾滋病毒阳性状况对于艾滋病毒预防和护理实施战略至关重要。因此,重要的是探索决定个人披露其艾滋病毒阳性状态的因素,以实现零新增艾滋病毒感染的目标。2013年7月至8月,在Axum卫生机构的361名HIV阳性成年人中进行了基于设施的混合横断面研究。他们是通过系统随机抽样选出的。数据由受过培训的咨询师和ART护士收集,然后输入SPSS 20版数据库。在95%置信区间和p值小于0.05的情况下,使用双变量和多变量逻辑回归模型来确定HIV阳性状态披露的预测因素。在361名受访者中,289人向某人透露了自己的艾滋病毒状况,151人(41.8%)向亲密伴侣透露了自己。在多变量逻辑回归分析中,p值<0.05显著相关的变量为已婚;了解伴侣的HIV状况和HIV支持小组的成员身份是披露的积极预测因素。这些发现得到了定性研究的支持,在该研究中,对歧视的恐惧、对保密的恐惧和对家庭的恐惧使他们隐瞒自己的身份。艾滋病毒阳性成年人中艾滋病毒阳性状况的披露率仍然很低。受访者的婚姻状况、对伴侣HIV状况的了解以及是否是抗HIV/AIDS协会的成员被确定为HIV阳性状况披露的预测因素。建议解决披露问题,以鼓励自由披露和应对负面反应,这是坚持治疗的关键方式。关键词:成人,Axum卫生设施,埃塞俄比亚,HIV阳性披露。
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Determinant factors of HIV positive status disclosure among adults in Axum Health Facilities, Northern Ethiopia: Implication on treatment adherence
Disclosure of HIV positive status to sexual partners, friends or relatives is crucial for HIV prevention and care implementation strategies. Hence, it is important to explore factors determining individuals to disclose their HIV positive status in order to achieve a goal of zero new HIV infection. Facility based mixed cross-sectional study was conducted from July to August, 2013 among 361 HIV positive adults attending Axum Health Facilities. They were selected through systematic random sampling. Data were collected by trained counselors and ART nurses and then entered into SPSS version 20 databases. Bivariate and multivariable logistic regression models were used to identify predictors of HIV positive status disclosure at 95% confidence intervals and p-value of less than 0.05. Among 361 respondents, 289 disclosed their HIV status to someone and 151(41.8%) to intimate partners. In the multivariate logistic regression analysis, variables significantly associated at p-value <0.05 were married; knowing partner’s HIV status and membership in an HIV-Support Group were positive predictors of disclosure. These findings were supported by qualitative study in which fear of discrimination,   fear of breaking confidentiality and fear of families make them to conceal their status. The rate of HIV positive status disclosure among HIV positive adults has remained low. Marital status of respondents, knowledge of partners’ HIV status and being member in Anti- HIV/AIDS Association were identified as predictors of HIV positive status disclosure. Addressing the issues of disclosure was recommended to encourage free disclosure and coping with negative reactions, which is a crucial way for adherence to treatment. Key words:  Adult, Axum health facilities, Ethiopia, HIV positive disclosure.
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