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皖北农村地区艾滋病社区支持影响因素及其模式研究

Research on the Influencing Factors and Mode of AIDS Community Support in Rural Areas of North Anhui

【作者】 马李

【导师】 叶冬青;

【作者基本信息】 安徽医科大学 , 流行病与卫生统计学, 2007, 硕士

【摘要】 目的了解皖北地区健康居民的艾滋病知识、态度、行为(KAP)情况,为农村社区艾滋病反歧视和社区支持工作提供决策参考。方法采取配额抽样方法,抽取临泉和利辛两县当地长期居住社会各阶层居民(18~64岁)1033名,采用自制健康居民艾滋病知、态、行调查表进行问卷调查。结果调查对象中,98.4%的人听说过艾滋病。日常生活不传播HIV的相关问题回答完全正确的比例为22.9%;三大传播途径回答完全正确的比例为42.3%;艾滋病相关知识完全答对的比例为12.1%。在不同的艾滋病假定角色情况下,只有当家人患此病时,才有68.4%的人持积极帮助关心的态度。多元线形回归分析结果显示,文化程度和艾滋病相关知识得分与艾滋病歧视程度负相关。仅有15.4%的人有过帮助艾滋病患者的经历。结论部分调查对象掌握最基本的AIDS知识,这与皖北农村地区艾滋病高发的氛围和政府有力的健康宣传有关,但歧视现象严重并可能长期存在。另外有>1/2的人不认为他们与此病有任何关系,即意识不到艾滋病现在已成为一个社会性问题。应采用有效的干预和宣传措施消除社区歧视,有力地动员整个农村社区各阶层居民一起来抵抗艾滋病。目的在定量调查的基础上,结合定性访谈进一步了解皖北农村地区艾滋病社区支持现状与需求。方法采用关键人物访谈及座谈形式,对艾滋病社区中的相关人员进行访谈,访谈内容主要涉及当地艾滋病防治现状、社区支持需求及建议咨询等。结果完成各类人群访谈44人,座谈19次。结果显示,艾滋病的社会歧视现象严重存在,基层医疗机构设施严重不足,基层医生是防控艾滋病的薄弱环节。经济窘迫、医疗资源匮乏,农村社区建设亟待加强。结论皖北农村地区的基层医疗服务,艾滋病社区支持及关爱工作需要进一步改善,以HIV感染者/AIDS患者为中心,周围邻居为依托的社区支持模式亟待建立。目的了解皖北农村地区HIV感染者/AIDS病人及其家属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(generic quality of life inventory-74,GQOLI-74)和社会支持评定量表(social support scale, SSS)对331名HIV感染者/AIDS病人及148名其家属进行调查。结果单因素分析显示,不同性别、不同乡镇、不同文化程度的HIV感染者/AIDS病人及其家属的GQOLI-74总分有着统计学差异(P<0.05);不同年龄、不同乡镇的HIV感染者/AIDS病人SSS总分有着统计学差异(P<0.05)。多元线性回归分析结果表明,高年龄、负性生活事件是影响HIV感染者/AIDS病人及其家属生活质量的不利因素,而高文化程度、好的邻里关系、烦恼诉说是影响HIV感染者/AIDS病人及其家属生活质量的有利因素。结论诸多因素在不同层面影响皖北农村地区HIV感染者/AIDS病人及其家属的生活质量和社会支持,我国农村现有的艾滋病社区关爱、社会支持工作还亟需加大力度,以家庭、邻里为依托的社区关爱模式有待建立。

【Abstract】 Objective To explore AIDS related knowledge, attitude and behaciors among the healthy inhabitants in North Anhui in order to provide policy recommendation of AIDS anti-discrimination and community support.Methods Self-designed questionnaire was used to investigate knowledge, attitude and behaciors for AIDS among 1033 healthy inhabitants in both linquan and lixin by quota sampling.Results 98.4% of subjects had heard AIDS with 42.3% of them knew three HIV transmission routes, but the awareness rate of non-transmission routes was 22.9%. 12.1% of subjects gained the full marks on the whole AIDS related questions. 68.4% of responders held active attitude if there was an HIV infector in the families. The multiple liner regression analysis revealed that higher education and scores of AIDS related questions were negative associated with AIDS discrimination. Only 15.4% of responders had the experience of helping PLWHAs.Conclusions Part of subjects had basic knowledge on AIDS because of the local high prevalence of HIV and powerful propaganda from government, but the discrimination was still serious which was likely to long-standing exist. In addition, more than 50% of responders don’t think they had any relationship with the disease, namely they were unconscious of the siocal problem. Effective intervention and propaganda should be used to eliminate the community discrimination, mobilize the whole community to resist against AIDS. Objective On the basis of quantitative interviews, qualitative interviews were used to understand the situation and demand of AIDS community suooprt in rural North Anhui. Methods Qualitative interviews coverd the persons who were related to AIDS community support were held in a face to face manner and symposium among keymen.The content of the interviews was about the situation of local AIDS prevention, the need of community support, suggestions.Results 44 participants took part in the focus group discussions and 19 symposia were held. The resluts revealed that social diacrimination to HIV exists badly, basic medical establishment were scarce seriously, the feeble tache exists in rural doctors. Confronting economic dilemma and lack of medical soured. Formation of rural communities urgently need to be accelerated.Conclusions Basic medical service, AIDS community support and concern need to improve. A mode of community care based on family and neighborhood is expected to established. Objective To explore quality of life and social support among people living with HIV/AIDS,and analyse the related factors.Methods 331 people living with HIV/AIDS and 148 of their family members were selected using typical sampling. General condition questionnaire, infected history survey table, generic quality of life inventory-74(GQOLI-74 ) and social support scale(SSS)were used.Results One-way analysis suggesteded that people living with HIV/AIDS and their family members with the different sexs, different villages and different culture degrees had difference in GQOLI-74 scores(P<0.05), people living with HIV/AIDS with the different villages had difference in SSS scores(P<0.05). Multiple linear regression analysis revealed that elders and negative life events were negative associated with social support(P<0.05),while the higher education, harmonious neighbor relationship, bother pouring were the predictive factors(P<0.05).Conclusions Many factors might affect dimensions of quality of life among people living with HIV/AIDS and their family members in rural north of Anhui, the communal care and social support of HIV/AIDS still should be enhanced greatly in Chinese country, a community care mode based on family and neighborhood is expected to established.

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