【摘要】 目的 了解广东省HIV感染孕产妇感知医疗环境歧视现状及相关因素，为减少医疗环境歧视提供参考依据。方法 在广东省21个地市招募2021年广东省报告的HIV感染孕产妇。通过自制电子问卷收集调查对象的基本情况、分娩情况、HIV感染相关信息、HIV耻辱、配偶/性伴HIV感染状态、个人权益认知、家庭暴力、社会组织参与及遭受医疗环境歧视等情况。采用χ~2检验和多因素非条件Logistic回归分析调查对象医疗环境歧视的相关因素。结果 360名调查对象的年龄中位数32(28,36)岁，医疗环境歧视报告率为35.3%(127/360)。多因素Logistic回归结果显示，知道HIV感染者个人权益得不到保障时可以投诉的孕产妇（a OR=0.48, 95%CI:0.28～0.85）感知到医疗歧视的概率更小、曾因感染HIV遭受家人暴力对待（a OR=3.37, 95%CI:1.49～7.91）以及高HIV耻辱水平（a OR=2.17, 95%CI:1.35～3.52）的孕产妇感知到医疗歧视的概率更大。结论 研究调查的HIV感染孕产妇遭受医疗环境歧视普遍存在，应更加关注个人权益认知低、遭受过家庭暴力、HIV耻辱水平高的调查对象，制定针对性干预措施，减少医疗环境歧视的发生。更多还原

【Abstract】 Objective To investigate the prevalence of discrimination against pregnant women living with human immunodeficiency virus(HIV) in healthcare settings in Guangdong Province and analyze its influencing factors to provide a reference for the reduction of discrimination in healthcare settings among this population. Methods In total, 2,021 HIVpositive pregnant women reported to be in Guangdong Province in 2021 were recruited from 21 prefecture-level cities. A self-designed questionnaire was used to collect data on basic information, reproductive information, HIV-related information, HIV stigma, HIV serostatus of spouse/sexual partners, family support, personal rights perceptions, family violence, social participation, and discrimination in healthcare settings. A Chi-squared test and multivariable nonconditional logistic regression analysis were conducted to explore factors associated with discrimination towards pregnant women living with HIV in healthcare settings. Results The median age of the 360 participants was 32 [interquartile range(IQR): 28, 36] years old, and the prevalence of discrimination towards pregnant women living with HIV in healthcare settings was 35.3%(127/360). Multivariable logistic regression analysis showed that pregnant women [adjusted odd ratio(aOR) =0.48, 95% confidence interval(CI): 0.28～0.85] who know that individuals infected with HIV can file complaints when their personal rights are not protected are less likely to perceive medical discrimination, pregnant women who have experienced domestic violence due to their HIV infection(aOR=3.37, 95%CI: 1.49-7.91) and those with high levels of HIV related stigma(aOR=2.17, 95%CI: 1.35～3.52) are more likely to perceive medical discrimination. Conclusions Discrimination against pregnant women living with HIV in healthcare settings in Guangdong is common. Special attention should be given to those with low awareness of personal rights, a history of domestic violence, and high HIV related stigma. Therefore, targeted interventions should be developed to reduce discrimination in healthcare settings.更多还原