Access to services and maintenance of safer sex practices among people living with HIV/AIDS

Access to services and their relationship to the maintenance of long-term safer sex practices are addressed in this study of 360 HIV+ adults recruited from outpatient medical facilities. Protease inhibitors, antiviral therapies, and entitlements were reported as the most needed services, while entitlements and money to pay for housing were reported as the largest unmet needs. Differences across ethnic and gender groups were observed. One-third of all respondents reported at least one occasion of unprotected anal or vaginal intercourse in the previous six months. The practice of unsafe sex was found to be significantly related to both the number of needed services and the number of unmet needs, even after controlling for demographic variables. In addition, a higher proportion of those who engaged in unsafe sex reported a higher need for psychological counseling and social support. These findings underscore the important linkage between access to services with avoidance of high-risk sexual behavior in HIV+ persons. Implications for the delivery of culturally appropriate, gender-specific and community-based interventions are discussed.     

Media activism and Internet use by people with HIV/AIDS

This paper seeks to understand better the media practices of people who are directly affected by an illness or health problem. Internet sites that have been created by people with HIV/AIDS are examined as a strategy for self-representation. This analysis identifies four prominent 'organising themes' in Internet sites: autobiography; expertise; self promotion; and dissent. It is argued that there is a connection between media activism within the contemporary AIDS movement and Internet use among people with HIV/AIDS. This paper discusses the potential of the Internet, as a form of media activism, to raise the private troubles of people with health problems as public issues through a revitalisation of the public sphere in contemporary post-industrial societies.     

艾滋病病毒感染者／艾滋病病人配偶／固定性伴HIV感染现状调查

[目的]了解艾滋病病毒(HIV)感染者和艾滋病(AIDS)病人配偶/固定性伴HIV感染现状,探索艾滋病病毒感染者及艾滋病病人(PLWHA)配偶/固定性伴降低胜接触传播的有效预防措施.[方法]对已确认的PLWHA的配偶/固定性伴采血进行HIV抗体检测.[结果]对全县可随访到的PLWHA的配偶/固定性伴73例进行了艾滋病毒抗体(抗-HIV)筛查,检出阳性23例,占31.51%.[结论]对PLWHA及其配偶/固定性伴进行健康教育、行为干预,是今后澄江县艾滋病控制工作的重点和难点.定期随访,指导PLWHA做到每次性交时正确使用安全套是减少配偶、性伴间传播HIV的有效方法.     

HIV感染者/AIDS患者危机干预

中国HIV感染者或AIDS患者(PLWHA)数目逐年增长,有关PLWHA的心理健康也成为社会关注的热点。在确诊HIV初期和艾滋病期的心理问题相对而言更严重,容易出现心理危机。目前心理危机干预技术多运用于其他疾病,在PLWHA的运用较少。本研究综述PLWHA危及期的心理特点及危机干预在PLWHA中的应用。     

HIV感染者和AIDS病人自杀意念现状及其影响因素研究

目的了解HIV感染者和AIDS病人（PeopleLivingwithHIV／AIDS,PLWHA）自杀意念现状,探讨其影响因素,为制定关怀干预对策提供客观依据。方法采用《自杀意念自评量表》（SIOSS）和评价方法,以2012年5月至2012年12月在广州市番禺区CDC艾滋病VCT门诊就诊的PLWHA为调查对象,进行面对面问卷调查,调查其人口学特征及对其是否持有自杀意念进行评价。采用多因素logistic回归分析对PLWHA的自杀影响因素进行统计学析。结果在调查的144例PLWHA中,男性占67．36％（97／144）,女性占32．64％（47／144）;平均年龄（36．9±10．8）岁。29．17％（42／144）患者有自杀意念。在自杀意念发生率方面,无业／待业者为（50．00％,9／18）高于有工作者（26．29％,33／126）、中专／高中及以下者为（32．52％,40／123）高于大专及以上者（9．52％,2／21）、独居者为（58．33％,7／12）高于非独居者（26．52％,35／132）、CD。细胞计数~〈200cells／μL者为（47．83％,11／23）高于〉200cells／μL者（25．62％,31／121）,差异均有统计学意义（均P〈0．05）。多因素logistic回归分析结果显示就业状况和居住方式为产生自杀意念的危险因素,其调整的OR值和95％CI分别为：4．813（1．250—18．526）和8．832（1．330～58．661）。结论PLwHA普遍存在自杀意念,应在随访关怀过程中,建立有效的综合支持体系,以改善PLWHA心理状况。     

2008－2014年中国艾滋病病毒感染者和艾滋病患者随访管理进展

目的 了解2008－2014年我国艾滋病病毒感染者/艾滋病患者(HIV/AIDS)随访管理工作进展。方法 采用随访干预、CD₄⁺T淋巴细胞(CD₄)检测和配偶/固定性伴HIV抗体检测3个指标分析随访管理工作进展,利用艾滋病综合防治数据信息系统中2008－2014年数据库,分析指标变化情况。结果 全国HIV/AIDS的随访干预率由2008年的55.7%上升到2014年的94.7%,CD₄检测率由2008年的48.4%上升到2014年的88.3%,配偶/固定性伴HIV抗体检测率由2008年的48.3%上升到2014年的91.1%。3项指标均逐年增长,经趋势χ²检验均有统计学意义(随访干预:χ²=180 466.733,P<0.01;CD₄:χ²=35 982.374,P<0.01;配偶检测:χ²=43 108.270,P<0.01)。注射吸毒途径HIV/AIDS随访干预率和配偶检测率较低,监管场所HIV/AIDS的3项指标均较低,感染途径不详者3项指标最低。结论 我国HIV/AIDS随访管理指标显著提高,HIV/AIDS得到有效随访管理服务。今后要加强注射吸毒途径感染以及监管场所HIV/AIDS的随访管理工作,首诊时加强个人信息的收集。     

HIV感染者/AIDS患者的家属及朋友感染HIV的相关因素分析

目的 探讨人类免疫缺陷病毒（human immunodeficiency virus,HIV）感染者/获得性免疫缺陷综合征（acquired immunodeficiency syndrome,AIDS）患者的家属及朋友感染HIV的现状和相关影响因素。方法 采取横断面研究设计,通过方便抽样方法和自行设计的调查问卷,于2013年3～6月对广州市第八人民医院感染科住院及门诊部的192名HIV感染者/AIDS患者的家属及朋友进行面对面问卷调查。结果 192位HIV感染者/AIDS患者的家属及朋友中,感染者家属占86.5%（166/192）,感染者家属及朋友的HIV感染率为36.5%（70/192）。多因素Logistic回归分析表明,与感染者的关系为配偶或性伴（OR=4.464,95%CI：2.128～9.366）、同性恋/双性恋（OR=4.523,95%CI：1.676～12.209）、吸毒（OR=6.755,95%CI：1.720～26.528）是感染者家属及朋友感染HIV的危险因素;与感染者感情关系亲密（OR=0.229,95%CI：0.097～0.539）是其感染HIV的保护因素。结论 HIV感染者/AIDS患者的配偶或性伴与其存在着性关系,故感染HIV风险较其他亲友高,但与HIV感染者/AIDS患者感情亲密的配偶或性伴较感情疏远者感染HIV风险低。同性恋/双性恋、吸毒是感染HIV的高危因素。关于与HIV感染者/AIDS患者感情关系和除配偶或性伴以外其他亲友感染HIV的相关关系,仍需进一步研究。     

Sexual risk behavior among people living with HIV/AIDS in Togo

Since HIV in Africa is spread primarily through unprotected sex, safe sex practices such as condom use can reduce HIV spread significantly. Nevertheless, because sexual behavior involves complex dynamics, condom use is not an easy option for many people in Africa despite years of condom distribution intervention. In fact, the complex nature of sexuality complicates efforts to combat HIV spread and limits the effectiveness of many prevention efforts. This paper uses theoretical explanations--social representation theory, situated rationality theory, and social action theory--to examine the patterns of sexual risk behavior and the underlying reasons and rationalization among people living with HIV/AIDS in Lomé, Togo. Qualitative interviews were conducted with 151 people living with HIV/AIDS, recruited from 3 HIV/AIDS centers. The results of this in-depth study suggest that although people living with HIV/AIDS may be aware of the risk of infecting their sexual partners, they deliberately ignore the risk because other considerations, such as wanting a baby, take precedence. Consequently, condom access is inadequate to change risky sexual behavior that spreads HIV. It must be supplemented with adequate empowerment.     

Social support and support groups among people with HIV/AIDS in Ghana

HIV/AIDS, a chronic burden in Ghana, poses social and health outcome concerns to those infected. Examining the Medical Outcome Study Social Support Survey (MOS-SSS) instrument among 300 Ghanaians from a cross-sectional design, Principal Component Analysis yielded four factors (positive interaction, trust building, information giving, and essential support), which accounted for 85.73% of the total variance in the MOS-SSS. A logistic regression analysis showed that essential support was the strongest predictor of the length of time an individual stayed in the support group, whereas positive interaction indicated negative association. The study’s implications for policy, research, and practice were discussed.     

安徽省项目地区艾滋病病毒感染者/病人艾滋病相关知识和行为变化分析

目的 了解安徽省艾滋病综合防治示范区/全球基金艾滋病项目地区艾滋病病毒感染者/病人的艾滋病知识和行为变化情况,为评估项目执行效果提供依据.方法 2007年12月采用整群抽样,对8个县(市、区)796名艾滋病病毒感染者/病人进行问卷调查,并与2006年8月开展的中期评估调查结果比较艾滋病相关知识和行为的变化.结果 专项调查和项目中期评估中该人群艾滋病知识平均知晓率分别为92.58%和92.01%,差异无统计学意义;专项调查中"关于无偿献血是否传播艾滋病"、"每隔6个月以上献血对身体是否有害"的正确率,以及上述两个问题均正确的比例分别为82.66%、83.67%和66.81%,高于中期评估的72.45%、68.38%和57.02%,差异均有统计学意义;专项调查和中期评估显示最近1次与配偶性生活时安全套使用率分别为95.25%和91.42%,差异有统计学意义;艾滋病病毒感染者和初中及以上文化程度者安全套使用率明显上升,分别由中期评估的89.82%、90.32%上升到专项调查的95.96%和97.75%,差异有统计学意义.结论 艾滋病病毒感染者/病人行为干预效果较为显著,但仍需加强无偿献血和部分艾滋病知识的宣传以进一步提高和维持部分知识知晓率.     

我国西南边境地区传染病防控体系存在的问题及原因分析

  目的  了解广西艾滋病感染者对艾滋病防治工作的满意程度,发现广西艾滋病防治的问题,并提出相应的卫生策略。  方法  于2016年10月,本研究采用自编艾滋病防治工作满意度调查问卷,采用分层整群抽样调查999名广西艾滋病感染者对艾滋病防治工作的满意度。  结果  艾滋病感染者对艾滋病防治工作的满意度较好（艾滋病感染者对宣教、随访、政府救助、接受医疗服务时受到尊重、接受医疗服务时隐私保护、接受医疗服务时和义务人员交流中满意或很满意分别为83.5 %,91.8 %,61.8 %,88.1 %,91.7 %和92.5 %,各项满意度平均值为84.9 %,但对政府救助的满意度偏低（满意或很满意占61.8 %）。多因素分析发现,与农村相比,城市艾滋病感染者的宣教满意度、随访满意度、对政府救助满意度、接受医疗服务时隐私保护满意度比农村更低（OR值分别为0.434、0.416、0.578和0.559,P均 < 0.05）。治疗费用支付形式中,免费治疗组和其他（保险）的随访满意度较自费组高（OR值分别为4.903和9.311,P均 < 0.05）,部分自费和免费治疗组的接受医疗服务时的受到尊重满意度较自费组高（OR值分别为2.529和3.270,P均 < 0.05）,免费治疗、部分自费和其他组接受医疗服务时的隐私保护满意度较自费组高（OR值分别为6.446、7.396和13.444,P均 < 0.05）。  结论  建议提高艾滋病感染者的救助水平,加强对城镇感染者的宣传教育、随访以及提高医疗服务质量,以提高广西艾滋病的防治能力。     

Physician and infection control practitioner HIV/AIDS reporting characteristics.

We surveyed a random sample of South Carolina physicians and infection control practitioners about the reporting of human immunodeficiency virus (HIV) and acquired immunodeficiency syndrome (AIDS) cases. Of physicians surveyed, 79% indicated that HIV infection as well as AIDS should be reported by name. The following characteristics were associated with those physicians who do not report AIDS cases: not feeling responsible for reporting, not reporting a case perceived to have been reported in another state, believing that information required for reporting is not on the chart, and residing in an urban setting. Targeted education can address these underreporting factors.     

对823例艾滋病感染者／病人的疫情分析

[目的]对宣威823例HIV感染者进行分析，提出建议，为政府和相关部门全面开展艾滋病防治工作，有效遏制艾滋病的传播和蔓延提供决策依据。[方法]收集和整理宣威自开展艾滋病防治工作以来至2007年12月底前累计发现的823例HIV感染者的相关信息，分别从性别、年龄、民族、职业、婚姻状况、文化程度、地区分布和传播途径等方面进行分析。[结果]宣威的艾滋病感染以注射吸毒传播为主，大多是20岁～49岁的青壮年人群，学历层次普遍较低，农民所占比例较大，未婚男性人数较多，主要集中在城区和城区附近乡（镇、街道）。[结论]必须进一步加大工作力度，积极采取过硬措施，真正做到市、乡、村一体，多部门联动、全社会参与，以确保宣传教育、咨询检测、告知随访及治疗关怀救助等工作措施落到实处。     

艾滋病病毒感染者生活质量与相关耻辱的关系

目的探讨艾滋病病毒感染者和病人的生活质量与耻辱的关系。方法对215名艾滋病病毒感染者和病人进行匿名问卷调查,采用WHO生活质量简表中文版和BergerHIV耻辱量表测定调查对象的生活质量和感受到的耻辱,对其生活质量和艾滋病相关耻辱感进行典则相关分析。结果艾滋病病毒感染者和病人生活质量各个维度的平均得分为50.74(生理领域)、46.01(心理领域)、53.78(社会关系领域)和43.94(环境领域);耻辱4个维度的得分为49.89(个人耻辱)、29.77(担心公开)、35.18(负面自我印象)和57.80(关注公众态度)。典则相关分析结果显示,自我负面印象和心理领域分别是耻辱和生活质量中起主要作用的因素,两者呈负相关,相关系数为0.4938(P<0.05)。结论艾滋病病毒感染者和病人的负面自我印象越小,生活质量心理方面越好。     

HIV/AIDS病人生活质量及社会支持调查

目的 了解皖北农村地区人类免疫缺陷病毒（HIV）感染者／艾滋病（AIDS）病人的生活质量和社会支持现状，分析其相关的影响因素。方法 通过典型抽样法采用一般情况问卷、感染史本底资料调查表、生活质量综合评定问卷（GQOLI-74）和社会支持评定量表（SSS）对85名HIV感染者／AIDS病人进行调查。采用单因素方差和多元线性回归方法对调查结果进行分析。结果 单因素分析显示，不同性别、不同文化程度的HIV感染者／AIDS病人GQOLI-74总分差异有统计学意义（P〈0．05）；不同乡镇的HIV感染者／AIDS病人SSS总分差异有统计学意义（P〈0．05）。多元线性回归分析结果表明，负性生活事件是影响HIV感染者／AIDS病人社会支持的不利因素。而好的邻里关系、烦恼诉说是影响HIV感染者／AIDS病人生活质量的有利因素。结论 诸多因素影响皖北农村地区HIV感染者／AIDS病人的生活质量和社会支持，农村应加强艾滋病社区关爱、社会支持工作，建立以家庭、邻里为依托的社区关爱模式。     

Children's use of general practitioner services in the five Nordic countries

OBJECTIVE: To compare socioeconomic, sociodemographic, and living area differences in children's use of GP services in five Nordic countries from the 1980s to the 1990s and to analyse trends during the period. DESIGN: Cross sectional population surveys using random samples comprising 3000 children aged 2-17 years were conducted in 1984 and 1996 in five Nordic countries. Time trends in use of GP services were studied in each country by age, sex, parents' highest level of education, and living area. SETTING: Five Nordic countries, Denmark, Finland, Iceland, Norway, and Sweden in 1984 and 1996. PARTICIPANTS: A total sample of 15 000 children aged 2-17 years. Altogether 3000 children were selected at random from the national population registers of the national bureaus of statistics in each country. MAIN OUTCOME: Health services utilisation on the basis of responses to a questionnaire item asking whether the parents had consulted a GP with regard to their children's health during the previous three months. MAIN RESULTS: The prevalence of children's utilisation of GP services varied from 14% in 1984 in Sweden to 28% in 1996 in Iceland. A clear time trend towards increasing utilisation of GP services (p<0.05) was found in all countries except in Denmark. Odds ratios for time trends (1984 = 1.00) varied from 1.22 (1.02 to 1.46) in Sweden to 1.92 (1.62 to 2.30) in Norway. After adjusting for independent variables, a statistically borderline significant declining utilisation trend (OR = 0.85 (0.70 to 1.03)) was found for Denmark. CONCLUSION: Children's use of GP services has increased significantly in four of the five Nordic countries.     

Demograghic and socio-economic determinants of community and hospital services costs for people with HIV/AIDS in London.

We examined the influence of demographic, social and economic background of people with HIV/AIDS in London on total community and hospital services costs. This was a retrospective study of community and hospital service use, needs and costs based on structured questionnaires administered by trained interviewers and costing information obtained from the service purchasers and providers, based on two Genito-urinary Medicine clinics in London: the Jefferiss Wing at St. Mary's Hospital and Patric Clements at the Central Middlesex Hospital, London, England. The subjects were 225 HIV infected patients (105 asymptomatic, 59 symptomatic non-AIDS and 61 AIDS). We found that over and above well established determinants of health care costs for HIV infected people such as disease stage and transmission category, social and economic factors such as employment and support of a living-in partner significantly reduced community services costs. Private health insurance had a similar effect, though only a small proportion of HIV people had such cover. The cost of community services for HIV infected non-European Union nationals, mainly of African origin, was one quarter that for the European Union nationals. Community services costs were highest for heterosexually infected women and lowest for heterosexually infected men after adjusting for other factors. Hospital services costs were significantly higher for HIV infected people lacking educational qualifications and employment. We conclude that access to community care for HIV infected non-EU nationals appears to be very poor as the cost of their community services was one quarter that for the EU nationals after adjusting for the effects of transmission category, disease stage, living with a partner, employment and having a private health insurance. Additional incentives for informal care for HIV infected people could be a cost-effective way to improve their community health service provisions.     

Peer support to promote medication adherence among people living with HIV/AIDS: the benefits to peers

Since early in the AIDS epidemic, HIV-positive individuals have benefited from the services of peer support or buddy programs. However, little research has focused on the experience of the peer providing support. We conducted qualitative interviews with nine HIV-positive peers who had participated in an intervention designed to provide support to other HIV-positive individuals as one means of promoting antiretroviral therapy adherence. Analyses of the peers' common dialogue about their involvement in the study revealed four main themes: social acceptance, reciprocal support, personal growth and empowerment, and resistance and other challenges. Recommendations for future research and for implementing similar interventions in a health care setting are provided.