医务人员对HIV/AIDS感染者歧视的原因分析

艾滋病自发现以来,受其感染者一直遭受着人们的歧视。对HIV/AIDS感染者的歧视,尤其是医务人员的歧视,加剧了HIV/AIDS感染者人群同社会的隔离,严重影响了我国艾滋病防治工作的开展。本文根据艾滋病的3个基本特点及被误解的传播途径,结合医务人员的职业特点,分析医务人员HIV/AIDS感染者歧视的直接原因,并提出相应的干预措施。     

多途径反歧视干预模式在艾滋病患者中的应用效果评价

中国在联大特别会议2010年国家进展报告中估计我国人类免疫缺陷病毒（HIV）／获得性免疫缺陷综合征（AIDS）的人数为74万左右［1］,但是近两年我国累计报告的 HIV／AIDS 只有22～32万例［2］,尚有4万多的 HIV ／AIDS 人群未进行检测和治疗,其中最重要的原因是艾滋病相关羞辱和歧视的存在。来自于家庭和社会各方面的羞辱和歧视使 HIV ／AIDS 人群失去了经济和情感支持,不能公平享有医疗卫生服务,被迫失业,普遍存在焦虑、抑郁,内疚或负罪感,自杀倾向和自杀病死率明显高于一般人群［3‐6］,这不仅使 HIV／AIDS 人群在生理、心理和社会生活等方面的受到很大的影响,而且也成为社会综合防治艾滋病的重大障碍。在我国,艾滋病相关羞辱和歧视的干预措施集中在通过大众传媒、各种形式的教育培训等提高人们的知识,增加大众对 HIV／AIDS 人群的可接受程度［7］。这些干预措施在短时期内起到了一定的效果,但是研究发现,单纯的宣传教育并不能完全改善人们对 HIV ／AIDS 人群的歧视态度,对他们生活质量的影响也很小［8］。国外对艾滋病相关羞辱和歧视的研究主要集中在探索如何降低 HIV／AIDS 人群感知到的羞辱和歧视,于是,强调感染者积极参与的干预项目是以后研究工作的重点。本研究以患者为中心,融合中国传统的家庭文化理念,建立以家庭为基础的艾滋病反歧视干预模式,为进一步开展社区艾滋病反歧视干预活动提供研究基础。     

影响HIV／AIDS态度、行为的原因分析

目的 通过对HIV／AIDS面临的社会压力、感受到的歧视及其反应的分析，来阐述减少歧视对预防和控制艾滋病的作用。方法 对已确认的HIV／AIDS患者，在知情、保密的情况下进行个人访谈；选择存在HIV／AIDS患者的村庄或附近村庄的居民，调查社区内存在的相关歧视及原因。结果 HIV／AIDS面临着较大的社会压力，43.8％的感染者感受到村民对他们的歧视。结论 应有计划、有步骤地扩大全民健康教育，宣传歧视和不尊重HIV／AIDs病人权利的危害性，从而通过减少歧视来预防和控制艾滋病。     

海洛因依赖者有关艾滋病知识、态度、信念及行为的调查

我国自1985年6月发现第一例艾滋病（AIDS）患者,到1999年底共报告1.7万例艾滋病病毒（HIV）感染者,其中,因注射毒品感染者占72.4%。目前我国吸毒人员68.1万,其中HIV感染者约占2%。目前惟一有效可行的AIDS防治战略就是健康教育,而健康教育的主体是AIDS高危人群。海洛因依赖者无疑是最重要的一类高危人群,他们对AIDS的知识、态度、信念和行为（KABP）将直接影响到AIDS的传播速度与数量［1］。本调查旨在了解武汉市的海洛因依赖者对AIDS知识的掌握程度和对AIDS预防的态度,为针对这类高危人群的AIDS健康教育提供背景资料和依据。     

菏泽市艾滋病病毒感染者生存现状的研究

目的 了解HIV感染者及AIDS病人的生存环境和生活质量，以建立适合我市实际的家庭和社会关怀和支持体系。方法 采取典型调查的方式调查已确认的HIV／AIDS患者，在知情、保密的情况下进行个人访谈；另外采用现况调查的方法，选择存在HIV感染者和AIDS病人的村庄或附近村庄的居民，调查社区内存在的相关歧视及原因。结果 HIV／AIDS患者存在着健康状况恶化、就医困难、经济窘迫、遭受歧视等的生存危机。结论 应有计划、有步骤地扩大全民健康教育，宣传歧视和不尊重HIV／AIDS病人权利的危害性，真正消除对艾滋病恐惧；建立对感染者和病人的保护机制；提供关怀、护理、社会和情感支持等的预防控制措施。     

医务人员在艾滋病防治工作中的健康教育问题探讨

加强医护人员防治艾滋病健康教育,从伦理学角度探讨艾滋病社会防治综合措施,强化医务人员艾滋病防治知识和技能培训,建立完善的艾滋病防治规范和组织机构,提出保护健康人群、促进医务人员对艾滋病的理性认识,为HIV／AIDS人群创造一个宽容的伦理关爱环境,有效遏止艾滋病的蔓延。     

艾滋病病毒感染者生存现状的调查研究

目的了解HIV感染者及AIDS病人的生存环境和生活质量,加强社会关怀支持工作。方法采取问卷调查的方式调查已确认的HIV/AIDS患者,在知情、保密的情况下进行个人访谈;另外选择存在HIV感染者和AIDS患者的社区居民,调查存在的相关歧视及其原因。结果HIV/AIDS患者存在着健康状况恶化,就医困难,经济窘迫,遭受歧视等生存危机。结论应有计划地在普通人群中进行宣传教育,制定有效的措施,降低社会对艾滋病的恐惧、歧视,减少由艾滋病病毒感染者引发的社会问题,为艾滋病患者提供社会性的关怀和情感支持。     

常州市某区AIDS/HIV感染流行情况的分析报告

目的为了探讨我区AIDS/HIV感染情况和流行特征,为今后政府制定我区艾滋病防治工作的政策提供理论依据。方法对2005年前后我区发现的AIDS/HIV感染者从年龄、性别、感染途径和分析方式等方面进行对比分析。结果我区AIDS/HIV感染在2005年前属低流行期,2005年后进入了快速增长期,2008、2009年发现的患者数均成倍增长,总体呈递增的趋势,且与感染者的年龄、职业、籍贯、传染途径等因素有关。结论我区AIDS/HIV感染者已进入快速增长阶段,女性感染者和中老年感染者明显增多,以性行为传播途径的感染者逐年增多,艾滋病的流行已从高危人群向普通人群蔓延。     

桂西地区258例HIV/AIDS患者艾滋病认知行为调查

目的对桂西地区HIV/AIDS患者的艾滋病相关认知水平、态度和行为进行调查和分析,为我地区更好地制定艾滋病防治措施提供参考。方法对桂西地区2014年6月~2015年6月确诊为HIV/AIDS的258例患者进行问卷调查。设计符合该地区实际情况的调查问卷,问卷的内容包含:一般资料,艾滋病知识的认知、态度与行为等。统计并分析调查结果,以便为艾滋病防控措施的制定提供数据支持。结果我地区HIV/AIDS患者对艾滋病知识的认知情况较差,大部分艾滋病知识题目的正确率<60%,例如对于与艾滋病病人日常行为接触是否感染艾滋病的正确率仅为22.87%;HIV/AIDS患者对艾滋病感染者的相关态度较好,绝大部分患者支持尊重和保护被感染者;HIV/AIDS患者选择安全性行为的比例较低,部分患者经常存在高危性行为。结论桂西地区HIV/AIDS患者对艾滋病相关知识的认知不全面、存在高危性行为。针对我地区HIV/AIDS患者的实际情况,必须进一步加强干预和健康教育,尽可能切断艾滋病的传播途径。     

艾滋病病毒感染者生存现状的调查研究

目的 了解HIV感染者及AIDS病人的生存环境和生活质量,加强社会关怀支持工作.方法 采取问卷调查的方式调查已确认的HIV/AIDS患者,在知情、保密的情况下进行个人访谈;另外选择存在HIV感染者和AIDS患者的社区居民,调查存在的相关歧视及其原因.结果 HIV/AIDS患者存在着健康状况恶化,就医困难,经济窘迫,遭受歧视等生存危机.结论 应有计划地在普通人群中进行宣传教育,制定有效的措施,降低社会对艾滋病的恐惧、歧视,减少由艾滋病病毒感染者引发的社会问题,为艾滋病患者提供社会性的关怀和情感支持.     

油田居民性病/艾滋病知识、态度和行为的调查

目的：了解油田居民对性病／艾滋病的知晓程度。方法：整群随机抽取油田居民2619名，采取无记名问卷方式对性病／艾滋病防治基础知识、防治态度、行为以及获取有关知识的途径等进行调查。结果：对我国规定管理的性病种类知晓率53．8％；性病传播途径知晓率62．5％；经性交和输血传播途径的回答正确率分别为85．1％、62．3％；性病的危害性知晓率59．0％；性病的预防措施知晓率59．1％。获取性病／艾滋病知识的主要来源为报刊（81．4％）；电视（48．8％）、科普小册子（40．7％）和宣传画（40．0％）；87．7％的人认为性病／艾滋病可以预防；57．5％的人认为感染性病后首选公立医院就医。结论：应进一步开展多样的性病／艾滋防治知识健康教育，以促进健康信念和行为的形成。     

Primary care physicians and AIDS. Attitudinal and structural barriers to care

OBJECTIVE--To explore the extent to which primary care physicians are providing health care for people with human immunodeficiency virus (HIV) infection and to document barriers to HIV care giving. DESIGN--National random-sample mailed survey. PARTICIPANTS--Population-based random sample of 2004 US general internists, family physicians, and general practitioners in 1990. Response rate was 59%. MAIN OUTCOME MEASURES--HIV treatment experience, willingness to treat HIV-infected patients, negative attitudes toward homosexuals and intravenous drug users, fear of contagion of the acquired immunodeficiency syndrome (AIDS), perceived lack of information about AIDS, and time demands of HIV care. RESULTS--Most physicians (75%) had treated one or more patients with HIV infection. A majority (68%) believed that they had a responsibility to treat people with HIV infection, yet half (50%) indicated that they would not, if given a choice. Over 80% of respondents believed that they lacked information about AIDS and that caring for people with AIDS is time consuming. Further, 35% of respondents agreed that they "would feel nervous among a group of homosexuals" and 55% expressed discomfort about having intravenous drug users in their practice. Physicians who had treated 10 or more HIV-infected patients expressed less negativity toward members of these stigmatized groups who are likely to be HIV infected. CONCLUSIONS--These data suggest that many primary care physicians are responding professionally to the AIDS epidemic but that attitudinal barriers may be hindering some physicians from providing treatment to HIV-infected patients.     

艾滋病和结核病双重感染的研究进展

近年来有两个传染病特别引起医学界的高度重视。其中之一是1981在美国发现的艾滋病；另一个就是自古以来在世界各地流行的结核病。两者相距数万年，传播途径迥然不同，但两者之间关系却很密切，容易先后或同时感染上这两种疾病，从而导致艾滋病和结核病双重感染。艾滋病和结核病双重感染成为公共卫生领域亟待解决的问题。现就HIV／TB双重感染的流行状况、双重感染的机制和关系、临床特点和诊断、预防和治疗等方面作介绍。     

HIV and AIDS in aboriginal and Torres Strait Islander Australians: 1992-1998. The National HIV Surveillance Committee

OBJECTIVE: To describe the epidemiological pattern of newly diagnosed HIV infection and AIDS among Indigenous Australians. DESIGN AND SETTING: National surveillance for newly diagnosed HIV infection and AIDS in Australia. Information on Indigenous status was sought at HIV/AIDS notification in all State/Territory health jurisdictions, except the Australian Capital Territory, and Victoria before June 1998. MAIN OUTCOME MEASURES: Number of people with newly diagnosed HIV per year and population rate of HIV diagnosis; demographic characteristics of people with HIV and AIDS diagnoses by Indigenous status. RESULTS: From 1992 to 1998, 127 Indigenous Australians were newly diagnosed with HIV infection and 55 were diagnosed with AIDS. The population rate of HIV diagnosis among Indigenous Australians (5.23/100,000 per year) was similar to that among non-Indigenous Australians (5.51/100,000 per year). The annual number of HIV diagnoses among Indigenous people was relatively stable, but among non-Indigenous people it declined steadily over time. A higher proportion of Indigenous people diagnosed with HIV were women (26.8% v 8.9%; P < 0.001). Although male homosexual contact was the predominant source of exposure for both Indigenous (46.7%) and non-Indigenous (75.0%) people with HIV infection, exposure by heterosexual contact (36.7% v 15.3%; P < 0.001) was reported more frequently among Indigenous people. CONCLUSION: Although HIV incidence was similar among Indigenous and non-Indigenous Australians, the lack of a recent decline in incidence and the higher proportion of Indigenous people exposed to HIV by heterosexual contact indicate the need to intensify interventions to prevent HIV transmission among Indigenous people.     

Management of HIV disease in China.

This brief report is concerned with the management of HIV infection since the 1980's in China. Mention was made of the 2-day Sino/American Symposium on Management of HIV Disease held in Beijing in 1990. Attendance included 600 participants from China and the US. 40 experts presented papers on topics covering diagnosis, treatment, research, prevention, psychology, sociology, ethics, education, and law. The Chinese Minister of Public Health and President of the Chinese Medical Association urged a unified and multiregional and multinational effort and a global network to combat HIV disease. Since the 1980's the Chinese government has instituted measures of prevention and control and recognized the harmful effects to health and life. Since 1985, 300,000 of the high risk population have received blood serum tests, of which 446 were found to be HIV positive. 5 were AIDS patients, of which 3 were foreigners and the other 2 from Beijing and Yunnan Province (southwest region) respectively. Included in the HIV positive group were 68 foreigners and 378 mainland Chinese. There have been no reported cases of mother/child infection. Drug users are identified as the high risk group for contracting and spreading the HIV infection. The number of drug users has increased rapidly, particularly along border regions of the southwest, and the method of use has been identified as intravenous injection. AIDS is now considered by the Chinese government as an infectious disease. There are monitoring stations in almost all provinces. The Ministry of Public Health has 3 laboratories for diagnosis of the HIV virus. A strain of HIV-1 virus has been isolated from a foreign tourist and used to prepare a diagnostic antigen. 5 units currently have P--grade laboratories for researching the etiology and molecular biology of AIDS. Research in medical institutes is also progressing on the use of traditional Chinese medicine to treat AIDS. Cooperation between China and the World Health Organization has led to the allocation of 300,000 US dollars for AIDS prevention and education with exchanges of foreign and Chinese experts. Public health publicity is the only available prevention tool, and the past efforts will be continued in order to reach all walks of life.     

论艾滋病歧视及反歧视对策

艾滋病是最受歧视的疾病之一,这是因为人们恐惧艾滋病,以及艾滋病传播途径的特殊性使人们习惯于将它和某些特定的行为生活方式联系在一起,从而将疾病与人格品质相关联,个别媒体的不当报道更加助长了人们的这种不当认识;某些医疗机构也有歧视和漠视艾滋病人的现象,病人正当就医权利屡被侵犯,维权之路举步维艰;歧视已成为艾滋病防治工作的最大障碍,它使高危行为者排斥检测,并强化了社会公众的恐惧心理。反对歧视任重道远,要从完善法律法规反歧视条款增强可操作性,加强宣传和政策倡导,落实有关责任,加强医德医风建设,培养医务人员医学人文精神等方面着手,做出长期而艰苦的努力。     

鄂西南某少数民族聚居区HIV感染者/AIDS病人干预前后生存质量比较

目的 了解鄂西南某少数民族聚居区HIV感染者/AIDS病人干预前后的生存质量,评价干预措施的效果,为更好地开展该地区AIDS防制工作提供科学依据.方法 采用《个人基本情况调查表》了解研究对象的一般情况及艾滋病相关知识的掌握情况,简体中文版MOS-HIV量表评价HIV感染者/AIDS病人的生存质量,SPSS16.0软件进...     

艾滋病疫苗与免疫

艾滋病（获得性免疫缺陷综合征）是由感染性艾滋病病毒所引起严重危害人类健康的疾病,它是一种病死率高、传播途径广的传染性疾病.艾滋病病毒通过攻击CD4＋T细胞来破坏机体的免疫系.统,研制出艾滋病疫苗是控制此病的最有效手段,而目前的研究成果并不理想,仍需要进一步探究免疫系统与艾滋病的发生发展间的相互作用.     

Impact of HIV infection on tuberculosis

Tuberculosis is increasing in prevalence in many countries and is now the leading infectious cause of death world wide, being responsible for three million deaths annually. Infection with HIV, likewise increasing in prevalence, has emerged as the most important predisposing factor for developing overt tuberculosis in people co-infected with Mycobacterium tuberculosis. Owing to the widespread geographical overlap of these two infections, it is estimated that in 1999, HIV related tuberculosis will reach one million cases and will cause 30% of the expected 2.5 million AIDS related deaths. Tuberculosis in HIV infected individuals may have unusual clinical features and can cause diagnostic difficulties. Despite the effectiveness of modern short course treatment, the mortality of HIV related tuberculosis during and after treatment remains high, and this may be due to other HIV related infections. The "cursed duet" of infection with both HIV and M tuberculosis is generating a threat to human health of unparalleled proportions which, if not taken seriously by health workers and decision makers, could become totally unmanageable.     

影响HIV／AIDS患者的心理行为因素与心理干预

HIV／AIDS已成为危害公众生命健康,危及社会稳定的严重传染病。在艾滋病还是不治之症的今天,对艾滋病的心理支持干预和治疗尤为重要。HIV／AIDS是一种行为疾病,心理社会因素加剧了HIV到AIDS的发展进程,对HIV／AIDS患者进行心理干预治疗,激发了病人的社会责任感,提高了治疗的依从性,减少了HIV感染对个人、家庭、社会的不良影响,干预也能使病人重返工作,并尝试找回正常人的感受。