文章摘要
韩冰峰,袁千里,刘姜,刘雅琼,黄宁华,崔富强.我国4个省份慢性乙型肝炎患者受到性与生育歧视现状调查[J].中华流行病学杂志,2020,41(4):504-507
我国4个省份慢性乙型肝炎患者受到性与生育歧视现状调查
Studies on sexual and childbearing-related stigma against chronic hepatitis B patients in four provinces in China
收稿日期:2019-06-03  出版日期:2020-04-24
DOI:10.3760/cma.j.cn112338-20190603-00389
中文关键词: 慢性乙型肝炎  歧视  性行为  生育
英文关键词: Chronic hepatitis B  Stigma  Sex behavior  Childbearing
基金项目:北京大学医学部专项(BMU20170607)
作者单位E-mail
韩冰峰 北京大学公共卫生学院 100191  
袁千里 北京市疾病预防控制中心 100013  
刘姜 北京大学公共卫生学院 100191  
刘雅琼 北京大学公共卫生学院 100191  
黄宁华 北京大学公共卫生学院 100191  
崔富强 北京大学公共卫生学院 100191 cuifuq@126.com 
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中文摘要:
      目的 了解中国当前慢性乙型肝炎(乙肝)患者遭受性与生育歧视的情况,为探究减少性与生育歧视策略提供依据。方法 从北京市、河南省、广东省和陕西省4个省份采用便利抽样选择5家医院乙肝患者采用自制问卷调查中国4个省份的慢性乙肝患者遭受性与生育歧视现状,使用方差分析和χ2检验比较不同人口学特征的性行为与生育歧视得分差异。结果 共调查797名慢性乙肝患者,4.15%(28/675)的患者被医生建议不要生育,4.67%(10/210)的女性患者被医务人员或计划生育服务机构建议终止怀孕。分别有3.62%(25/690)和3.48%(24/690)的患者因感染HBV被拒绝提供计划生育服务和生殖健康服务。男性患者中, ≤ 30岁组遭受性与生育歧视的程度低于31~岁组(P=0.011)和 ≥ 51岁组(P=0.009);女性患者中,31~岁组遭受性与生育歧视的程度低于 ≤ 30岁组(P=0.003)而高于41~岁组(P=0.001)和 ≥ 51岁组(P<0.001)。知晓HBV性传播途径的患者较不知晓的患者更可能有不发生性行为的想法(P=0.022)。而知晓安全套可以减小HBV感染风险知识的患者较不知晓的患者在发生性行为想法上差异无统计学意义(P=0.612)。结论 慢性乙肝患者存在遭受性与生育相关的歧视,尤其是处在31~40岁的女性。需要普及安全套阻断性传播的知识和实施母婴阻断策略,更好地保护乙肝患者性行为和生育的权利。
英文摘要:
      Objective This study intended to explore the current sexual and childbearing stigma, experienced by chronic hepatitis B patients in China, and to develop related preventive strategies. Methods We used a self-made questionnaire to investigate the sexual and childbearing stigma suffered by chronic hepatitis B patients in four provinces of China. Analysis of variance and chi-square test were used to compare the differences on sexual and childbearing stigma indexes between different demographic variables. Results We surveyed 797 chronic hepatitis B patients in four provinces. Among them, 4.15% (28/675) of the patients were persuaded not to give birth to children, and 4.67% (10/210) of patients were told to stop pregnancy, by their medical care takers or by members from the family planning institutions. 3.62% (25/690) and 3.48% (24/690) of the patients were not able to enjoy the family planning or reproductive health services as they were stigmatized,suffered, as having HBV infection. Among the male chronic hepatitis B patients, the under 30 years group suffered less sexual and childbearing stigma than those who were aged 31-(P=0.011) or 51 and above year-olds (P=0.009). Among female chronic hepatitis B patients, the 31-year-olds group suffered less sexual and childbearing stigma than those under 30 years group but higher than those aged 41-(P=0.001) or 51 and above ones (P<0.001). Patients with knowledge on route of sexual transmission for HBV, were more likely to practice less related sexual behaviors than those without such knowledge (P=0.022). Patients who were aware or not that condoms could reduce the risk of HBV infection did not show statistically significant difference on sex behaviors (P=0.612). Conclusions Chronic hepatitis B patients did suffer from sexual and childbearing related stigma, with women aged 31-40 years old the most. It is necessary to advocate on the advantage of condom use for prevention of HBV transmission among pregnant women, both horizontally and vertically. Strategies on protection the rights of patients with hepatitis B should be developed and strengthened.
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