Gielen A C, McDonnell K A, Wu A W, O'Campo P, Faden R
Department of Health Policy & Management, School of Hygiene and Public Health, Johns Hopkins University, Baltimore, MD 21205, USA.
Soc Sci Med. 2001 Jan;52(2):315-22. doi: 10.1016/s0277-9536(00)00135-0.
This paper describes the relationship between psychosocial factors and health related quality of life among 287 HIV-positive women using items from the Medical Outcomes Study HIV Health Survey to measure physical functioning, mental health and overall quality of life. Multivariate models tested the relative importance of sociodemographic characteristics, HIV-related factors and psychosocial variables in explaining these quality of life outcomes. A history of child sexual abuse and adult abuse, social support and health promoting self-care behaviors were the psychosocial factors studied. Women in the sample were on average 33 years old and had known they were HIV-positive for 41 months; 39% had been hospitalized at least once due to their HIV; 83% had children; 19% had a main sex partner who was also HIV-positive. More than one-half of the women (55%) had a history of injection drug use and 63% reported having been physically or sexually assaulted at least once as an adult. A history of childhood sexual abuse. reported by 41% of the sample, was significantly related to mental health after controlling for sociodemographic and HIV-related characteristics. Women with larger social support networks reported better mental health and overall quality of life. Women who practiced more self-care behaviors (healthy diet and vitamins, adequate sleep and exercise, and stress management) reported better physical and mental health and overall quality of life. The high prevalence of physical abuse and child sexual abuse reported by this sample underscores the importance of screening for domestic violence when providing services to HIV-positive women. That such potentially modifiable factors as social support and self care behaviors are strongly associated with health-related quality of life suggests a new opportunity to improve the lives of women living with HIV.
本文使用医学结局研究HIV健康调查中的项目，描述了287名HIV阳性女性的心理社会因素与健康相关生活质量之间的关系，以测量身体功能、心理健康和总体生活质量。多变量模型检验了社会人口学特征、HIV相关因素和心理社会变量在解释这些生活质量结果方面的相对重要性。儿童期性虐待和成年期虐待史、社会支持和促进健康的自我护理行为是所研究的心理社会因素。样本中的女性平均年龄为33岁，已知自己HIV呈阳性已有41个月；39%的人因HIV至少住院过一次；83%的人有孩子；19%的人的主要性伴侣也是HIV阳性。超过一半的女性（55%）有注射吸毒史，63%的人报告成年后至少遭受过一次身体或性侵犯。在控制了社会人口学和HIV相关特征后，41%的样本报告有儿童期性虐待史，这与心理健康显著相关。社会支持网络较大的女性报告的心理健康和总体生活质量较好。实施更多自我护理行为（健康饮食和维生素、充足睡眠和锻炼以及压力管理）的女性报告的身心健康和总体生活质量较好。该样本报告的身体虐待和儿童期性虐待的高发生率凸显了在为HIV阳性女性提供服务时筛查家庭暴力的重要性。社会支持和自我护理行为等潜在可改变因素与健康相关生活质量密切相关，这为改善HIV感染女性的生活提供了新机会。
