Marseille 2007
Marseille 2007
Abstract book
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Abstract #312  -  Disclosure and religion among people living with HIV/AIDS in France.
Session:
  26.108: Posters B (Poster) on Tuesday   in  Chaired by
Authors:
  Presenting Author:   Dr PREAU MARIE - INSERM U379 / ORS PACA, France
 
  Additional Authors:  Msc Marcellin Fabienne , Dr Malavolti Laetitia , Dr Le Corroller Soriano Anne-Galle, Dr Lert France , Prof Moatti Jean-Paul, Dr Spire Bruno ,  
Aim:
Experience of discrimination attitudes has been shown to be associated with mental health, impaired quality of life and depressive disorders in the context of both HIV infection and cancer disease. The aim of this study was to compare patients experience of discrimination in the two disease situations, to determine the factors associated with such experience and to evaluate its impact on patients lives among two representative samples of patients.
 
Method / Issue:
We used data provided by two national studies: firstly the VESPA study, conducted among a representative sample of people living with HIV and AIDS (PLWHA) being followed up in France (n=2,932) and secondly the ALD-CANCER study which included patients two years after they had been diagnosed with cancer (n=4,270), this latter population being representative of data provided by the French national health system. Psychosocial data, including discrimination assessment were collected using face-to-face (VESPA) or telephone (ALD-CANCER) interviews of patients. We performed logistic regression models to identify factors associated with patients reports of discrimination behaviours.
 
Results / Comments:
Nine percent of patients from the ALD-CANCER study and 47% of PLWHA from the VESPA study (Chi-square test: p<.0001) reported having already suffered from discriminative behaviours. Young age (odd ratio [95% confidence interval] for a 10-year increment = 0.6 [0.6; 0.7] and 0.7 [0.6; 0.8] respectively for cancer patients and PLWHA), discomfort due to treatment-related side effects (2.1 [1.6; 2.7] and 1.5 [1.3; 1.9]), financial difficulties (1.6 [1.2; 2.1] and 1.7 [1.4; 2.1]) and the use of psychoactive drugs (1.7 [1.4; 2.2] and 1.5 [1.2; 1.8]) were all significantly associated with experience of discrimination in the context of cancer and HIV infection. HIV transmission through injecting drug use (1.2 [0.9; 1.5]), lipodystrophy syndrome (1.6 [1.3; 1.9]), female gender (1.5 [1.1; 1.9]), lack of a main partner (1.4 [1.1; 1.7]); and non-migrant origin (1.5 [1.2; 2.0]) were specific factors independently associated with discrimination among PLWHA. Finally, patients suffering from lung cancer were more prone to experiencing discrimination behaviours than other cancer patients (1.5 [1.1; 2.2]).
 
Discussion:
Our study shows a higher prevalence of discrimination against HIV as it was encountered by almost half of the PLWHA questioned. Active or former injecting drug users report discrimination more frequently. HIV discrimination is associated with factors that are population specific in French PLWHA. Difficulties associated with side effects during treatment and a poor affective life are factors that could be managed and improved by medical or psychosocial interventions. Our study underlines the different fields that generate discriminatory behaviours according to the type of disease (e.g. cancer vs HIV infection). The stigmatisation associated with smoking may explain the higher proportion of patients with lung cancer who report discrimination.
 
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