Jewkes R, Dunkle K, Nduna M, Levin J, Jama N, Khuzwayo N, Koss M, Puren A, Duvvury N
Gender and Health Research Unit, Medical Research Council, Private Bag X385, Pretoria 0001, South Africa.
Int J Epidemiol. 2006 Dec;35(6):1461-8. doi: 10.1093/ije/dyl218. Epub 2006 Sep 28.
This paper aims to describe factors associated with HIV sero-status in young, rural South African women and the relationship between intimate partner violence (IPV) and HIV.
A total of 1295 sexually active female volunteers, aged 15-26, from 70 villages were recruited to participate in a cluster randomized controlled trial of an HIV behavioural intervention. The main measures were HIV sero-status, and IPV and sexual practices measured using a questionnaire administered during baseline interviews.
About 12.4% of women had HIV and 26.6% had experienced more than one episode of physical or sexual IPV. After adjusting for age, HIV infection was associated with having three or more past year partners [odds ratio (OR) 2.39; 95% confidence interval (95% CI) 1.48-3.85], sex in past 3 months (OR 3.33; 95% CI 1.87-5.94), a partner three or more years older (OR 1.69; 95% CI 1.16-2.48), and a more educated partner (OR 1.91; 95% CI 1.30-2.78). IPV was associated with HIV in two-way analyses (OR 1.56; 95% CI 1.08-2.23), but the effect was non-significant after adjusting for HIV risk behaviours. The experience of IPV was strongly associated with past year partner numbers, time of last sex, and partner's education; it was also marginally associated with partner age difference. Adverse experiences in childhood, including sexual abuse, increased the likelihood of having more past year partners (OR 1.43; 95% CI 1.21-1.69).
IPV was strongly associated with most of the identified HIV risk factors. Our findings provide further evidence of links between IPV and HIV among women and the importance of joint prevention.
本文旨在描述南非农村年轻女性中与艾滋病毒血清学状态相关的因素，以及亲密伴侣暴力（IPV）与艾滋病毒之间的关系。
从70个村庄招募了1295名年龄在15 - 26岁之间有性行为的女性志愿者，参与一项艾滋病毒行为干预的整群随机对照试验。主要测量指标为艾滋病毒血清学状态，以及在基线访谈期间通过问卷调查测量的IPV和性行为。
约12.4%的女性感染了艾滋病毒，26.6%的女性经历过不止一次身体或性方面的亲密伴侣暴力。在调整年龄后，艾滋病毒感染与过去一年有三个或更多性伴侣[比值比（OR）2.39；95%置信区间（95%CI）1.48 - 3.85]、过去3个月有性行为（OR 3.33；95%CI 1.87 - 5.94）、伴侣比自己大三岁或以上（OR 1.69；95%CI 1.16 - 2.48）以及伴侣受教育程度更高（OR 1.91；95%CI 1.30 - 2.78）相关。在双向分析中，亲密伴侣暴力与艾滋病毒相关（OR 1.56；95%CI 1.08 - 2.23），但在调整艾滋病毒风险行为后，该效应不显著。亲密伴侣暴力经历与过去一年的性伴侣数量、最后一次性行为时间以及伴侣的教育程度密切相关；也与伴侣年龄差异略有相关。童年时期的不良经历，包括性虐待，增加了过去一年有更多性伴侣的可能性（OR 1.43；95%CI 1.21 - 1.69）。
亲密伴侣暴力与大多数已确定的艾滋病毒风险因素密切相关。我们的研究结果进一步证明了女性中亲密伴侣暴力与艾滋病毒之间的联系以及联合预防的重要性。
