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Article(id=1241322664086795147, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1241322661654098823, articleNumber=null, orderNo=null, doi=10.20043/j.cnki.MPM.202308226, pmid=null, cstr=null, oa=null, hot=null, price=null, onlineType=0, articleFormat=0, articleType=null, articleTypeStr=null, receivedDate=1694016000000, receivedDateStr=2023-09-07, revisedDate=null, revisedDateStr=null, acceptedDate=null, acceptedDateStr=null, onlineDate=1773883985778, onlineDateStr=2026-03-19, pubDate=1706112000000, pubDateStr=2024-01-25, doiRegisterDate=null, doiRegisterDateStr=null, onlineIssueDate=1773883985778, onlineIssueDateStr=2026-03-19, onlineJustAcceptDate=null, onlineJustAcceptDateStr=null, onlineFirstDate=null, onlineFirstDateStr=null, sourceXml=null, magXml=null, createTime=1773883985778, creator=13701087609, updateTime=1773883985778, updator=13701087609, issue=Issue{id=1241322661654098823, tenantId=1146029695717560320, journalId=1227665162245664772, year='2024', volume='51', issue='2', pageStart='193', pageEnd='384', issueExtLink='null', onlineDate='null', pubDate='null', beforeIssueId=null, nextIssueId=null, price=null, status=1, issueComplete=1, articleOrder=1, issueType=-1, specialIssue=null, createTime=1773883985198, creator=13701087609, updateTime=1773890256678, updator=13701087609, preIssue=null, nextIssue=null, ext={EN=IssueExt(id=1241348966214849502, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1241322661654098823, language=EN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=), CN=IssueExt(id=1241348966214849503, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1241322661654098823, language=CN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=)}, issueFiles=null}, startPage=285, endPage=290, ext={EN=ArticleExt(id=1241322664380396428, articleId=1241322664086795147, tenantId=1146029695717560320, journalId=1227665162245664772, language=EN, title=Analyses of social support for young and middle-aged HIV/AIDS patients in Luzhou City based on community follow-up management model, columnId=1228016572892119056, journalTitle=Modern Preventive Medicine, columnName=Primary Health Services, runingTitle=null, highlight=null, articleAbstract=
Objective

To apply Social Network Analysis(SNA) to analyze the characteristics of the social support network from 18 to 50 years old HIV/AIDS patients receiving community follow-up management in Luzhou City, and to provide a basis for the development of social support and health intervention work.

Methods

A quota sampling method was used, with young and middle-aged HIV/AIDS patients receiving community follow-up management in Luzhou City as the survey subjects. A social support network matrix questionnaire was designed, and a relationship matrix was constructed using Excel 2016. The social support network characteristics were analyzed using UCINET 6.0 software, and a 2-mode social network graph was drawn using Net-Draw.

Results

The social support scores of 165 young and middle-aged HIV/AIDS patients who received community follow-up management in Luzhou City were 24.15±8.10, as follows: hospital(2.45), community(2.36), family(2.16), new media(1.65), traditional media(1.59), friends(1.47), relatives(1.30), social organizations(1.18), colleagues(0.95), and neighbors(0.83); The overall density matrix of the social support network is 1.59, with a core edge final goodness of fit of 0.61, indicating a good fit. Among them, hospitals and communities had the highest centrality and were located in the main core position, while family and new media were in the secondary core position. The rest were situated in the periphery.

Conclusion

The social support level of young and middle-aged HIV/AIDS patients receiving community follow-up management in Luzhou City is relatively low, mainly relying on support from hospitals, community health service centers, family, new media, and social organizations as supplementary sources. In the future, it is recommended to establish a social support network with hospitals and communities as the core, utilizing family members as bridges. Furthermore, expanding the social support network through social organizations and implementing internet-based health interventions can increase the variety and intensity of support, improve the patients’ quality of life, and also serve as a reference for other regions.

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目的

应用社会网络分析法（SNA）分析泸州市接受社区随访管理的中青年（18~50岁）HIV/AIDS患者社会支持主体网络特征，为开展社会支持、健康干预工作提供依据。

方法

采用定额抽样方法以泸州市接受社区随访管理的中青年HIV/AIDS患者作为调查对象，设计社会支持网络矩阵问卷，使用Excel 2016编制关系矩阵，使用ucinet 6.0软件分析社会支持网络特征，NetDraw绘制2-mode社会网络图。

结果

泸州市接受社区随访管理的165名中青年HIV/AIDS患者的社会支持得分24.15±8.10分，各维度依次为医院（2.45），社区（2.36），家庭（2.16），新媒体（1.65)，传统媒体（1.59），朋友（1.47），亲戚（1.30），社会组织（1.18），同事（0.95），邻居（0.83）；社会支持网络整体密度矩阵为1.59，核心-边缘最终拟合优度0.61，拟合较好；其中医院、社区的中心度最高，位于主核心位置，家庭和新媒体位于次核心位置，其余位于边缘位置。

结论

泸州市接受社区随访管理的中青年HIV/AIDS患者社会支持水平较低，主要依赖于医院、社区卫生服务中心，家庭、新媒体和社会组织集合的支持作为补充。建立以医院-社区为核心，家属为桥梁的社会支持网络，结合社会组织拓宽社会支持网络，开展互联网形式健康干预，增加其支持种类数量和力度，提高其生活质量，也可为其他地区提供借鉴。

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李爱玲，E-mail：
, copyrightStatement=本刊刊出的所有文章不代表中华预防医学会和本刊编委会的观点，除非特别声明。, copyrightOwner=中华预防医学会和四川大学华西公共卫生学院, extLink=null, articleAbsUrl=null, sourceXml=pz3GXr+8NvmBizR+kdZcAw==, magXml=VaNdBfVUYJhMDTDFA/C8ug==, pdfUrl=null, pdf=Izo17wmDnacQw2e1q5UNoA==, pdfFileSize=1064073, pdfExtLink=null, richHtmlUrl=null, mobilePdfUrl=null, reviewReport=null, pdfFirstPage=null, abstractGraph=QqLhQ/Wzdm8zIGXfhrIFCg==, abstractGraphContent=null, abstractVideo=null, citation=null, cebUrl=null, magXmlContent=NfkASCu5btWFGq/VOOHWTw==, mapNumber=null, authorCompany=null, fund=null, authors=

陈小雪（1994—），女，硕士，助教，研究方向：基层艾滋病防治，健康教育与健康促进

叶雨婷（2002—），女，本科在读，研究方向：公共卫生与预防医学

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陈小雪（1994—），女，硕士，助教，研究方向：基层艾滋病防治，健康教育与健康促进

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Changsha: Central South University, 2010., articleTitle=Research on NGO participation in the field of AIDS prevention and control -- A case study ofYunnan province, refAbstract=null)], funds=[Fund(id=1241322671254859965, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241322664086795147, awardId=21YYJC0578, language=CN, fundingSource=西南医科大学校级课题(21YYJC0578), fundOrder=null, country=null)], companyList=[AuthorCompany(id=1241322665642881969, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241322664086795147, xref=null, ext=[AuthorCompanyExt(id=1241322665647076274, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241322664086795147, companyId=1241322665642881969, language=EN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=School of Public Health, Southwest Medical University, Luzhou, Sichuan 646000, China), AuthorCompanyExt(id=1241322665651270580, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241322664086795147, companyId=1241322665642881969, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=西南医科大学公共卫生学院，四川 泸州 646000)])], figs=[ArticleFig(id=1241322670206283901, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241322664086795147, language=EN, label=Fig.1, caption=Social support network for young and middle-aged HIV/AIDS patients (ties have value≥3), figureFileSmall=CdD70naNrVL/jwYpJzDMdQ==, figureFileBig=QqLhQ/Wzdm8zIGXfhrIFCg==, tableContent=null), ArticleFig(id=1241322670281781379, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241322664086795147, language=CN, label=图1, caption=中青年HIV/AIDS患者社会支持网络（ties have values≥3）, figureFileSmall=CdD70naNrVL/jwYpJzDMdQ==, figureFileBig=QqLhQ/Wzdm8zIGXfhrIFCg==, tableContent=null), ArticleFig(id=1241322670512468114, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241322664086795147, language=EN, label=Fig.2, caption=Social support network for young and middle-aged HIV/AIDS patients (ties have values≥3，degree≥2), figureFileSmall=EI42JU+rOo0x6eYqlkWoFQ==, figureFileBig=Kzyv6eMPBzYt7qZY5Fx12g==, tableContent=null), ArticleFig(id=1241322670575382679, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241322664086795147, language=CN, label=图2, caption=中青年HIV/AIDS患者社会支持网络（ties have values≥3，degree≥2）, figureFileSmall=EI42JU+rOo0x6eYqlkWoFQ==, figureFileBig=Kzyv6eMPBzYt7qZY5Fx12g==, tableContent=null), ArticleFig(id=1241322670650880156, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241322664086795147, language=EN, label=Table 1, caption=

General situation of young and middle-aged HIV/AIDS patients in Luzhou City (n=165)

, figureFileSmall=null, figureFileBig=null, tableContent=
项目人数构成比（%）项目人数构成比（%）
性别男12776.97居住地农村2615.76
女3823.03城镇13984.24
文化程度文盲-小学169.69婚姻状况未婚8853.33
初中-高中7746.67已婚/同居4829.09
大专及以上7243.64离婚/分居2716.36
丧偶10.61
合计165100.00165100.00
), ArticleFig(id=1241322670734766240, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241322664086795147, language=CN, label=表1, caption=

泸州市中青年HIV/AIDS患者一般情况（n=165）

, figureFileSmall=null, figureFileBig=null, tableContent=
项目人数构成比（%）项目人数构成比（%）
性别男12776.97居住地农村2615.76
女3823.03城镇13984.24
文化程度文盲-小学169.69婚姻状况未婚8853.33
初中-高中7746.67已婚/同居4829.09
大专及以上7243.64离婚/分居2716.36
丧偶10.61
合计165100.00165100.00
), ArticleFig(id=1241322670810263714, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241322664086795147, language=EN, label=Table 2, caption=

Social support score situation of young and middle-aged HIV/AIDS patients in Luzhou City

, figureFileSmall=null, figureFileBig=null, tableContent=
社会支持来源HIV/AIDS分值得分率（%）
医院2.45±1.1342.42(70/165)
社区2.36±1.1846.06(76/165)
家庭2.16±1.2335.76(59/165)
新媒体1.65±1.1224.24(40/165)
传统媒体1.59±1.1419.39(32/165)
朋友1.47±1.0917.58(29/165)
亲戚1.30±1.1416.36(27/165)
社会组织1.18±1.1714.55(24/165)
同事0.95±0.958.48(14/165)
邻居0.83±0.927.27(12/165)
), ArticleFig(id=1241322670919315624, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241322664086795147, language=CN, label=表2, caption=

泸州市青年HIV/AIDS患者社会支持得分情况

, figureFileSmall=null, figureFileBig=null, tableContent=
社会支持来源HIV/AIDS分值得分率（%）
医院2.45±1.1342.42(70/165)
社区2.36±1.1846.06(76/165)
家庭2.16±1.2335.76(59/165)
新媒体1.65±1.1224.24(40/165)
传统媒体1.59±1.1419.39(32/165)
朋友1.47±1.0917.58(29/165)
亲戚1.30±1.1416.36(27/165)
社会组织1.18±1.1714.55(24/165)
同事0.95±0.958.48(14/165)
邻居0.83±0.927.27(12/165)
), ArticleFig(id=1241322671028367535, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241322664086795147, language=EN, label=Table 3, caption=

Perceived social support centrality of young and middle-aged HIV/AIDS patients (n=165)

, figureFileSmall=null, figureFileBig=null, tableContent=
序号集合度数中心度接近中心度中间中心性度
1医院0.960.940.16
2社区0.940.910.15
3家庭0.900.840.14
4新媒体0.840.770.10
5传统媒体0.800.740.09
6朋友0.800.730.09
7亲戚0.700.650.06
8社会组织0.670.630.06
9同事0.620.590.04
10邻居0.560.560.04
), ArticleFig(id=1241322671133225140, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241322664086795147, language=CN, label=表3, caption=

中青年HIV/AIDS患者感知的社会支持中心度（n=165）

, figureFileSmall=null, figureFileBig=null, tableContent=
序号集合度数中心度接近中心度中间中心性度
1医院0.960.940.16
2社区0.940.910.15
3家庭0.900.840.14
4新媒体0.840.770.10
5传统媒体0.800.740.09
6朋友0.800.730.09
7亲戚0.700.650.06
8社会组织0.670.630.06
9同事0.620.590.04
10邻居0.560.560.04
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基于社区随访模式管理的泸州市中青年HIV/AIDS患者社会支持分析
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陈小雪 , 叶雨婷 , 吕馨月 , 华涵 , 郎杰那么 , 范颂 , 陈润 , 李爱玲
现代预防医学 | 基层卫生服务 2024,51(2): 285-290
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现代预防医学 | 基层卫生服务 2024, 51(2): 285-290
基于社区随访模式管理的泸州市中青年HIV/AIDS患者社会支持分析
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陈小雪, 叶雨婷, 吕馨月, 华涵, 郎杰那么, 范颂, 陈润, 李爱玲
作者信息
  • 西南医科大学公共卫生学院，四川 泸州 646000

    • 陈小雪（1994—），女，硕士，助教，研究方向：基层艾滋病防治，健康教育与健康促进

    叶雨婷（2002—），女，本科在读，研究方向：公共卫生与预防医学

通讯作者:

李爱玲，E-mail：
Analyses of social support for young and middle-aged HIV/AIDS patients in Luzhou City based on community follow-up management model
Xiao-xue CHEN, Yu-ting YE, Xin-yue LV, Han HUA, LANG Jie-na-me, Song FAN, Run CHRN, Ai-ling LI
Affiliations
  • School of Public Health, Southwest Medical University, Luzhou, Sichuan 646000, China
出版时间: 2024-01-25 doi: 10.20043/j.cnki.MPM.202308226
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摘要
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目的

应用社会网络分析法（SNA）分析泸州市接受社区随访管理的中青年（18~50岁）HIV/AIDS患者社会支持主体网络特征，为开展社会支持、健康干预工作提供依据。

方法

采用定额抽样方法以泸州市接受社区随访管理的中青年HIV/AIDS患者作为调查对象，设计社会支持网络矩阵问卷，使用Excel 2016编制关系矩阵，使用ucinet 6.0软件分析社会支持网络特征，NetDraw绘制2-mode社会网络图。

结果

泸州市接受社区随访管理的165名中青年HIV/AIDS患者的社会支持得分24.15±8.10分，各维度依次为医院（2.45），社区（2.36），家庭（2.16），新媒体（1.65)，传统媒体（1.59），朋友（1.47），亲戚（1.30），社会组织（1.18），同事（0.95），邻居（0.83）；社会支持网络整体密度矩阵为1.59，核心-边缘最终拟合优度0.61，拟合较好；其中医院、社区的中心度最高，位于主核心位置，家庭和新媒体位于次核心位置，其余位于边缘位置。

结论

泸州市接受社区随访管理的中青年HIV/AIDS患者社会支持水平较低，主要依赖于医院、社区卫生服务中心，家庭、新媒体和社会组织集合的支持作为补充。建立以医院-社区为核心，家属为桥梁的社会支持网络，结合社会组织拓宽社会支持网络，开展互联网形式健康干预，增加其支持种类数量和力度，提高其生活质量，也可为其他地区提供借鉴。

社会网络分析法  /  艾滋病  /  中青年患者  /  社会支持主体
Objective

To apply Social Network Analysis(SNA) to analyze the characteristics of the social support network from 18 to 50 years old HIV/AIDS patients receiving community follow-up management in Luzhou City, and to provide a basis for the development of social support and health intervention work.

Methods

A quota sampling method was used, with young and middle-aged HIV/AIDS patients receiving community follow-up management in Luzhou City as the survey subjects. A social support network matrix questionnaire was designed, and a relationship matrix was constructed using Excel 2016. The social support network characteristics were analyzed using UCINET 6.0 software, and a 2-mode social network graph was drawn using Net-Draw.

Results

The social support scores of 165 young and middle-aged HIV/AIDS patients who received community follow-up management in Luzhou City were 24.15±8.10, as follows: hospital(2.45), community(2.36), family(2.16), new media(1.65), traditional media(1.59), friends(1.47), relatives(1.30), social organizations(1.18), colleagues(0.95), and neighbors(0.83); The overall density matrix of the social support network is 1.59, with a core edge final goodness of fit of 0.61, indicating a good fit. Among them, hospitals and communities had the highest centrality and were located in the main core position, while family and new media were in the secondary core position. The rest were situated in the periphery.

Conclusion

The social support level of young and middle-aged HIV/AIDS patients receiving community follow-up management in Luzhou City is relatively low, mainly relying on support from hospitals, community health service centers, family, new media, and social organizations as supplementary sources. In the future, it is recommended to establish a social support network with hospitals and communities as the core, utilizing family members as bridges. Furthermore, expanding the social support network through social organizations and implementing internet-based health interventions can increase the variety and intensity of support, improve the patients’ quality of life, and also serve as a reference for other regions.

Social network analysis  /  HIV/AIDS  /  Young patients  /  Social support subject
陈小雪, 叶雨婷, 吕馨月, 华涵, 郎杰那么, 范颂, 陈润, 李爱玲. 基于社区随访模式管理的泸州市中青年HIV/AIDS患者社会支持分析. 现代预防医学, 2024 , 51 (2) : 285 -290 . DOI: 10.20043/j.cnki.MPM.202308226
Xiao-xue CHEN, Yu-ting YE, Xin-yue LV, Han HUA, LANG Jie-na-me, Song FAN, Run CHRN, Ai-ling LI. Analyses of social support for young and middle-aged HIV/AIDS patients in Luzhou City based on community follow-up management model[J]. Modern Preventive Medicine, 2024 , 51 (2) : 285 -290 . DOI: 10.20043/j.cnki.MPM.202308226
正文
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截至2022年底，全国（不含港、澳、台地区）报告现存活HIV/AIDS患者有122.3万例，其中HIV感染者68.9万例，AIDS患者53.4万例[1]。其中青年的艾滋病感染率正在上升，成为艾滋病的高危人群之一[2]。由于艾滋病的传染性强、社会认知水平不足，艾滋病人群在社会交往中受到歧视和排挤[3-4]，被家人嫌弃和疏远[5]，得不到足够的社会支持，逐渐被边缘化。社区随访模式是一种重要的HIV/AIDS患者管理模式，社区随访模式强调在社区层面提供医疗和社会支持，以满足HIV/AIDS患者的健康需求，这一模式通过社区卫生工作者、志愿者和专业医护人员的协同合作，为患者提供连续的医疗和心理支持，帮助他们管理疾病，改善生活质量[6]。社会支持（social support）是指一定的社会网络（social network）运用物质和精神手段对弱势群体进行无偿帮助，使他们度过生存和发展困境的社会行为[7-8]，社会支持能促进个体的自尊、控制感和归属感，减轻压力[9]。社会网络是指社会行动者及其之间关系的集合，基本要素包括行动者（actor）、关系（relation）和群体（group）[10]，群体中的关系通过绘制关系网的方式呈现支持网络。社会行动者（Social Actor）用“点/核”（Node）表示事件、集合用“群体”（Group）表示，社会关系（Relation）用“线”（Lines）表示，关系网则是由“点”和“线”绘制的网络（Network）结构。本研究旨在基于社区随访模式管理，绘制2-mode社会网络图，对泸州市中青年HIV/AIDS患者的社会支持进行深入分析，以了解他们所面临的需求和挑战，以及如何提升社会支持水平，以期改善他们的生活质量。
1　对象与方法
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1.1　对象
现住址为四川省泸州市，居住时间≥6个月，年龄为18~50岁[11]，无认知缺陷，知情同意，能够配合完成调查的HIV/AIDS患者。依据泸州市2010—2020年HIV/AIDS病例报告数分布情况[12]，主要分布在合江县、泸县、江阳区、纳溪区和龙马潭区，选取管理HIV/AIDS患者人数≥200人的乡镇卫生院或社区卫生中心为调查点，对调查时间内所有到访青年HIV/AIDS患者进行调查。本研究已通过西南医科大学医学伦理委员会审查（编号：KY2022090）。
1.2　方法
采用自行设计的社会网络矩阵问卷进行面对面调查，问卷内容包括一般情况和社会支持矩阵量表[13]，共10个条目，包括来自各级医疗机构的支持，编码为医院；来自疾病预防控制中心/乡镇卫生院/社区卫生服务中心的支持，编码为社区；来自家庭成员如配偶、子女的支持，编码为家庭；来自亲属的支持，编码为亲戚；来自社区、村邻居的支持，编码为邻居；来自朋友的支持，编码为朋友；来自同事的支持，编码为同事；来自报纸、电视、广播的支持，编码为传统媒体；来自QQ、微信、短视频等社群的支持编码为新媒体；来自艾滋病相关社会组织、协会的支持，编码为社会组织。量表按照“从不”“偶尔”“一般”“经常”“总是”依次记0～4分，得分越高，说明支持越好。Excel 2016矩阵编制中，社会行动者使用阿拉伯数字进行编号；社会支持网络集合使用中文名词进行编号。
1.3　统计分析
一般情况、感染情况采用SPSS 20.0软件对计量资料和计数资料进行统计学分析，计量资料用（）表示，计数资料用例数和百分率（%）表示。
1.4　社会支持网络分析
Excel矩阵表导入ucinet 6.0软件，计算2-mode网络的矩阵密度（Avg Value）和中心度（centrality）；矩阵密度越大，说明社会行动者联系的越紧密，矩阵密度最终拟合优度≥0.8表明拟合非常好，≥0.6表明拟合较好，实现路径：network→cohesion properties→density→density overall，“中心度”包括：“度数中心度”（degree centrality） “接近中心度”（Closeness Centrality）和“中间中心度”（betweenness centrality）。“度数中心度”表示社会行动者社交关系能力大小，是点与其他点直接连接的总和，用size表示，一个节点的size越大，就说明其联结能力越大；“接近中心度”是衡量节点重要性的指标，表示节点到其他节点的“距离”（distance）的总和，越接近1，表明这个点到其他所有点的路径越短，行动者与行动者之间途径越短，联系越紧密；“中间中心度”表示社会行动者在社交网络所处位置，一个节点的最短路径的数量越多，说明它的中间中心度越高，位置越核心，中心度实现路径：network→centrality→2-mode centrality，中心度数值越大，越处于核心位置；使用Net Draw绘制2-mode网络：net draw→file→open→ucinet data-set→2-mode-network，点击analysis→centrality measures→对话框选择betweenness；当行动者表示能够“经常”“总是”获得社会支持：ties have values≥3，degree＝1表示行动者有一项社会支持来源，degree≥2表示行动者有两个及以上的社会支持来源。节点越大、距离核心越近、位置越集中的行动者集合联系越紧密，表示形成的核心区域具有较大的相似性[14]。
2　结果
收起
2.1　一般情况
调查期间对到访的181名中青年HIV/AIDS患者进行调查，符合条件问卷共165份，有效回收率91.96%，平均年龄为34.50±7.70岁；男性127人（76.97%），女性38人（23.03%）；居住在农村 26人（15.76%），城镇 139人（84.24%）；文化程度大专及以上72人（43.64%）、初、高中77人（46.67%）、小学及以下16人（9.69%）；婚姻状况：未婚88人（53.33%），已婚/同居48人（29.09%），离婚/分居27人（16.36%），丧偶1人 （0.61%）；见表1。
2.2　社会支持得分
社会支持得分依次为医院（2.45±1.13），社区（2.36±1.18），家庭（2.16±1.23），新媒体（1.65±1.12），传统媒体（1.59±1.14），朋友（1.47±1.09），亲戚（1.30±1.14），社会组织（1.18±1.17），同事（0.95±0.95），邻居（0.83±0.92）。行动者表示能够“经常”“总是”获得社会支持率来源依次为社区46.06%（76/165）医院49.70%（70/165），家庭35.76%（59/165），新媒体24.24%(40/165)，传统媒体19.39%（32/165），朋友17.58%(29/165)，亲戚16.36%（27/165），社会组织14.55%(24/165),同事8.48%(14/165)，邻居7.27%(12/165)。详见表2。
2.3　社会支持网络特征
2.3.1　矩阵密度
社会网络整体矩阵密度为（1.59±1.23），2-mode核心-边缘初始拟合优度指数（starting fitness）为0.73，最终拟合优度指数（final fitness）0.61，拟合较好。
2.3.2　中心度
医院中心度最高（度数中心度0.96，接近中心度0.94，中间中心度0.16），其次为社区（0.94,0.91,0.15），家庭（0.90,0.84，0.14），新媒体（0.84,0.77,0.10），传统媒体（0.80,0.74,0.09），朋友（0.80，0.73,0.09），亲戚（0.70,0.65,0.06），社会组织（0.67,0.63,0.06），同事（0.62,0.59,0.04）邻居（0.56,0.56,0.04），详见表3。
2.3.3　2-mode社会网络
社会支持网络结构如图1所示，有121个社会行动者参与并形成连接，社区和医院集合距离近，位于社会支持网络的中心，家庭集合和由新媒体、传统媒体、社会组织组成的集合位于社会支持网络的次中心，其余社会支持网络集合距离较远；删除degree＝1（表示行动者仅有一个获取社会支持的来源，社会支持集合之间无联结的社会网络节点），如图2所示，有79个社会行动者有来自两个以上的社会支持集合的支持；形成了医院-社区行动者结合、家庭行动者集合和新媒体集合三个范围；社区-医院集合是社会支持网络集合中的核心，家庭集合和新媒体集合是两个次核心，其余集合处于社会支持网络边缘位置，以图2中ID104为例，有35个社会行动者位于行动者网络核心位置，其余社会行动者位于行动者网络边缘位置，对比图2，图1有12个社会行动者（节点）仅从家属集合处获得支持，没有其他外部链接，连线较少，密度低，位于边缘位置。
3　讨论
收起
本次研究揭示了泸州市社区随访管理的中青年HIV/AIDS患者面临的社会支持问题，以及这些问题如何影响他们的生活和健康，结果显示，社会支持总分低于我国常模[15]，表明他们在面对HIV/AIDS疾病时获得的支持相对有限；中青年HIV/AIDS患者通常需要更多的社会支持，以应对疾病带来的身体和心理挑战，和来自社会的歧视和偏见。
本研究发现，医院和社区作为主要的社会支持来源，起到了至关重要的作用。超过一半的随访的中青年HIV/AIDS患者的社会支持来源于医院和社区，其中医院的中心度最高，位于核心位置，凝聚力最强。这是由于医院提供了医疗和心理支持，社区提供了日常生活中的协助，在青年HIV/AIDS患者社会支持网络中占有比较重要的地位，是艾滋病患者诊断和物质传递的核心，与患者联系紧密；此外，在过去的十几年中，各级医疗机构在日常诊疗活动中发现患者存在可疑感染后，会主动为就诊者提供检测和咨询服务，社区卫生中心为农村居民和城镇经济困难人员中的艾滋病患者免费发放抗病毒治疗药物，为他们提供医疗支持服务，在预防、治疗、关怀等方面取得了明显成效[16]，反映了社会机制和政府政策的积极作用，尤其是“四免一关怀”政策的推动。中国美沙酮维持治疗项目分析显示, HIV新发感染率逐年下降；随着抗病毒治疗覆盖率从2002年的0增加到2009年的63%,符合治疗标准病人的病死率从2002年的39/100人年下降到2009年的14/100人年,艾滋病病死率明显下降[17]。医院和社区卫生服务中心是艾滋病患者社会支持网络中的意见领袖（Key Opinion Leader，KOL）[18]，发挥了决定性的作用。同时，基于2020年四川省出台的《四川省遏制HIV/AIDS传播实施方案（2020-2022）》，泸州市作为国家HIV/AIDS综合防治示范区，制定了以遏制艾滋病性传播为重点，加强泸州地区人群的宣传教育，进一步加强了泸州地区HIV/AIDS人群的管理，使他们获得了有效的支持。
社会网络模型图呈现出泸州市接受社区随访管理的中青年HIV/AIDS患者社会支持网络格局与其他弱势群体的社会支持格局基本一致[7]，即以政府主导的正式组织支持为主，家庭等其他社会关系支持为辅，多元并举的社会支持系统。在他们的社会支持网络体系中，社区、医院的连线最多，距离最短，密度最大，位于核心结构区域，因此位于主核心位置；家庭支持位于次核心，这可能是由于人口变迁、家庭结构变化所造成的；不可忽视的是新媒体集合（24.85%）和传统媒体集合（20.00%）、社会组织形成的集合网络，对青年HIV/AIDS患者而言具有重要的支持作用。这是由于互联网时代来临，青年HIV/AIDS患者频繁使用社交网络，通过微信、微博、QQ等社交APP接触艾滋病知识机会更多、获得社会帮助更多，他们之间形成的社群有助于拓宽青年HIV/AIDS患者社会支持系统。在许多国家[19]，社会组织在艾滋病防治过程起重要作用,是艾滋病防治工作不可或缺的部分，年轻的艾滋病患者在虚拟网络社会中能够寻找慰藉，获得支持，这也是他们获得社会支持的特有方式。有研究表明[20]，E-Health通过互联网和相关技术提供或增强卫生服务和信息，艾滋病防治可以利用信息和通信技术来改善艾滋病患者的社会支持体系，未来将成为他们获得社会支持的重要环节。这提示针对中青年患者，可以利用虚拟网络社区得到应有的帮助，与高校、企业等非医疗机构的沟通协作，吸引更多的社会资源，提供志愿服务，补充政府卫生部门防治机构提供社会支持的短板[21]。
虽然本研究提供了有关中青年HIV/AIDS患者社会支持网络的重要洞察，但也存在一些局限性。首先，调查仅在泸州市范围内开展，因此结果的泛化性受到地域限制，难以直接适用于其他地区或不同背景的中青年HIV/AIDS患者。不同地区的社会支持网络结构可能因地方文化、政策和资源分配而异，因此需要谨慎推广研究结果。其次，调查采用面对面的问卷调查方式，仅对到访的中青年HIV/AIDS患者进行了调查，可能导致选择性偏向，因为某些患者可能由于不愿配合调查等未纳入，研究结果可能不完全反映泸州市所有中青年HIV/AIDS患者的实际情况。
4　结论
收起
综上所述，泸州市接受社区随访管理的中青年HIV/AIDS患者社会支持水平较低，主要从依赖于医院、社区卫生服务中心，家庭、新媒体和社会组织集合支持作为补充。未来建立以医院-社区为核心，家属为桥梁的社会支持网络，结合社会组织拓宽社会支持网络，开展互联网形式健康干预，增加其支持种类数量和力度，提高其生活质量，也可为其他地区提供借鉴。
基金
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  • 西南医科大学校级课题(21YYJC0578)
文献
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2024年第51卷第2期
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doi: 10.20043/j.cnki.MPM.202308226
  • 接收时间：2023-09-07
  • 首发时间：2026-03-19
  • 出版时间：2024-01-25
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  • 收稿日期：2023-09-07
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西南医科大学校级课题(21YYJC0578)
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    西南医科大学公共卫生学院，四川 泸州 646000

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2种不同金属材料的力学参数
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Number of
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鹅膏菌科Amanitaceae 2 11 5.26 鹅膏菌属 Amanita 10 4.78
小菇科 Mycenaceae 2 12 5.74 丝盖伞属 Inocybe 5 2.39
多孔菌科 Polyporaceae 8 14 6.70 蜡蘑属 Laccaria 5 2.39
红菇科 Russulaceae 3 23 11.00 小皮伞属 Marasmius 6 2.87
小菇属 Mycena 11 5.26
光柄菇属 Pluteus 5 2.39
红菇属 Russula 17 8.13
栓菌属 Trametes 5 2.39
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