Stigma, Discrimination and Other Social-Structural Factors Associated with Barriers to Counselling or Therapy among Women Living with HIV Who have Experienced Violence in Metro Vancouver, Canada

IF 2.7 2区医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

AIDS and Behavior Pub Date : 2024-09-23 DOI:10.1007/s10461-024-04456-2

Colleen Dockerty, Kate Shannon, Wendee Wechsberg, Colleen Thompson, Mary Kestler, Melissa Braschel, Kathleen Deering

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Abstract

Women living with HIV face high social and structural inequities that place them at heightened risk for gender-based violence and mental health conditions, alongside health services access inequities, with almost no research done to better understand access to mental health services. This study therefore examined social and structural factors associated with barriers to counselling or therapy amongst women living with HIV who experienced lifetime physical and/or sexual violence in Metro Vancouver, Canada. Bivariate and multivariable logistic regression using generalized estimating equations (GEE) were used and adjusted odds ratios (AOR) and 95% Confidence Intervals ([95%CIs] are reported). From Sept/15-Aug/21, 1695 observations were collected among 279 participants. In multivariable analysis, with all variables measured in the last six months, experiencing any barriers to counselling or therapy was significantly associated with having thoughts or attempts of suicide (AOR:1.64 [1.02–2.66]), lacking coverage for health care (AOR:1.60 [1.17–2.18]), and everyday discrimination (AOR:1.02 [1.00-1.04]) and anticipated (AOR:1.57 [1.04–2.36]), enacted (AOR:1.48 [1.02–2.16]) or internalized (AOR:1.53 [1.07–2.20]) HIV stigma. Access to interdisciplinary mental health care services should be improved. Social and structural interventions to reduce HIV stigma and discrimination are urgently needed.

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加拿大大温哥华地区曾遭受暴力的女性 HIV 感染者在接受咨询或治疗时所面临的耻辱感、歧视及其他社会结构因素。

感染艾滋病病毒的女性面临着严重的社会和结构性不平等，这些不平等使她们面临更高的性别暴力和心理健康问题的风险，同时还面临着医疗服务获取不平等的问题，几乎没有任何研究可以更好地了解心理健康服务的获取情况。因此，本研究探讨了与加拿大大温哥华地区终生遭受过身体暴力和/或性暴力的女性艾滋病感染者接受咨询或治疗的障碍有关的社会和结构性因素。研究采用了广义估计方程（GEE）进行二元和多元逻辑回归，并报告了调整后的几率比（AOR）和 95% 置信区间（[95%CIs]）。从 15 年 9 月至 21 年 8 月，共收集了 279 名参与者的 1695 个观测数据。在对过去 6 个月中的所有变量进行的多变量分析中，在咨询或治疗方面遇到任何障碍都与有自杀想法或自杀未遂显著相关（AOR:1.64 [1.02-2.66]）、缺乏医疗保障（AOR:1.60 [1.17-2.18]）、日常歧视（AOR:1.02 [1.00-1.04]）和预期的（AOR:1.57 [1.04-2.36]）、颁布的（AOR:1.48 [1.02-2.16]）或内在化的（AOR:1.53 [1.07-2.20]）艾滋病毒污名。应改善跨学科心理保健服务的获取途径。亟需采取社会和结构性干预措施来减少对艾滋病病毒的羞辱和歧视。

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来源期刊

AIDS and Behavior Multiple-

CiteScore

6.60

自引率

13.60%

发文量

382

期刊介绍： AIDS and Behavior provides an international venue for the scientific exchange of research and scholarly work on the contributing factors, prevention, consequences, social impact, and response to HIV/AIDS. This bimonthly journal publishes original peer-reviewed papers that address all areas of AIDS behavioral research including: individual, contextual, social, economic and geographic factors that facilitate HIV transmission; interventions aimed to reduce HIV transmission risks at all levels and in all contexts; mental health aspects of HIV/AIDS; medical and behavioral consequences of HIV infection - including health-related quality of life, coping, treatment and treatment adherence; and the impact of HIV infection on adults children, families, communities and societies. The journal publishes original research articles, brief research reports, and critical literature reviews. provides an international venue for the scientific exchange of research and scholarly work on the contributing factors, prevention, consequences, social impact, and response to HIV/AIDS. This bimonthly journal publishes original peer-reviewed papers that address all areas of AIDS behavioral research including: individual, contextual, social, economic and geographic factors that facilitate HIV transmission; interventions aimed to reduce HIV transmission risks at all levels and in all contexts; mental health aspects of HIV/AIDS; medical and behavioral consequences of HIV infection - including health-related quality of life, coping, treatment and treatment adherence; and the impact of HIV infection on adults children, families, communities and societies. The journal publishes original research articles, brief research reports, and critical literature reviews.5 Year Impact Factor: 2.965 (2008) Section ''SOCIAL SCIENCES, BIOMEDICAL'': Rank 5 of 29 Section ''PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH'': Rank 9 of 76