【作者】 张科； 陶小润； 康殿民；

【Author】 Jonathan pack Zhang Xiao-run Tao Dian-min Kang SD-CDCP 16992 Jing-shi Road,Ji-nan City,Shan-dong province 250014.

【机构】 山东省疾病预防控制中心；

【摘要】 "艾滋病实际上是一种行为性疾病,……改变行为是控制疾病和促进健康的重要策略措施。"由于公共卫生领域研究的局限性,使得艾滋病行为干预工作存在诸多瓶颈,如"知行分离"、男男性行为人群(MSM)新发感染率居高不下等难题长期难以化解,。对此,国内外学者正努力从心理学的角度寻求突破。艾滋病防治工作中的"一般人群"是指尚未或偶尔面临艾滋病传染风险的人群。对该人群的研究一是集中于"艾滋病恐惧症":国内研究主要是对症状的描述分析,未能对其诱发原因、发生机制等进行深入探讨;二是关注偏见与歧视:国外学者对歧视的形成、分类等环节都已经有了深入的研究,而国内学者则主要是在国外研究的基础上,对艾滋病相关歧视的程度和水平进行描述。"高危人群"包括暗娼(FSW)、男男性行为者(MSM)、吸毒人群(IDU)以及其他经常面临传染风险,但尚未被感染的人群。相关研究主要包括①"知行分离"问题:针对该问题国外学者提出了健康信念模型、AIDS风险削弱模型、阶段变化模型、社会认知理论、计划行为理论、理性行为理论等多种解释,而国内干预工作以及相关研究仍多以传统的健康信念模型为基础;②对阳性患者性伴/配偶的告知:具体研究内容包括安全告知、维护患者及其被告知者的心理健康,以及如何通过心理干预提升防治效果等。国内研究认为,干预工作关键在告知初期,重点在于对患者本人的安抚和对相关知识的普及,而国外学者则认为心理医生的介入、对家属和性伴侣的社区干预同样重要。"感染者和病人"是指已经感染免疫缺陷病毒(HIV)的人群或艾滋病患者。部分病人得知被感染后出现多种心理和行为问题,普遍的有性放纵、治疗依从性差及多种心理障碍等;较为极端的包括故意传播疾病、自杀等等。现有研究多关注治疗依从性和心理健康促进两个方面。有国外研究认为,治疗依从性由副作用、个人经验、社会支持等多种因素共同决定,而国内学者则更关注通过避免遗忘,以及增加社会支持两个维度。而心理健康促进工作中,国内学者多关注对该人群健康状况的观察以及对焦虑症、抑郁症的病理学研究。更多还原

【Abstract】 "In actually,AIDS is one kind of behavioral problem......to change one’s behavior is the key to control the disease and the importance of health promotion." However,due to the limitations of the public health science,there are still some difficulties in behavioral interventions, such as "Knowledge-behavior Desperation" etc.In this regard,scholars around the world are trying to seek a breakthrough from a psychological point of view. In the area of HIV/AIDS prevention and control,the "Normal people" refers to the part of the whole population which are not yet facing the risks of being infected by HIV or occasionally crowd those risks.The researchers on this population based studies focus on the "Fear of AIDS". The domestic researches mainly focus on the phenomena analysis,and fail to induce the reasons or the occurrence mechanism in depth.The other topics have more concern on HIV/AIDS-related stigma and discrimination.Foreign scholars already have in-depth studies on the mechanism and classification of stigma and discrimination.,However,the domestic researches,which are mainly based on the results of foreign studies,make some discretion on AIDS-related discrimination. The "High risk people" includes the female sex workers(FSW),men who have sex with men (MSM),drug users(DU) and those who often face the risks of HIV infection,but have not yet been infected.Related researches mainly include ?"Knowledge-behavior Desperation":On this topic,the foreign scholars have proposed the health belief model,the AIDS reduction model,the Trans-theoretical model,social cognitive theory,the theory of reasoned action,the theory of planned behavior and the information-motivation-behavioral skills model.The domestic interventions are mainly based on the traditional theory of "health beliefs model";? result notification to the partners of HIV positives:the researches focus on safely informing,the mental health of HIV positives and the partners,and how to improve the control effect through psychological intervention.The domestic studies suggest that the crucial stage of HIV intervention is at the beginning of result notification,especially attention should be taken on comforting the patients and informing the related-people sufficient relevant information.Besides,to the same topic,the foreign scholars believe that the involvement of a psychiatrist,family members and sexual partners in the intervention is equally important. The "PLWHA" refers to those who have been infected with HIV or have been developed to AIDS patients.Some PLWHAs suffer various psychological and behavioral problems,when they are notified the infected fact.The normal problems include sexual indulgence,poor treatment compliance and a variety of psychological disorders;some extreme problems include intended diseases transition,suicide and so on.For PLWHAs,existing researches pay more attention on treatment compliance and mental health promotion.Some foreign studies suggest that treatment compliance is determined by the side effects of medication,personal experience,social support, and some other factors,although the domestic scholars have more concern on how to decrease ignorance,and increase social support.To the mental health promotion work,the domestic scholars pay more attention on the observation of mental health status,for instance anxiety, depression pathology observations.更多还原