少数族裔、贫困人群及虐待幸存者：美国南部腹地的艾滋病毒感染患者。
Minorities, the poor, and survivors of abuse: HIV-infected patients in the US deep South.
作者信息
Pence Brian Wells, Reif Susan, Whetten Kathryn, Leserman Jane, Stangl Dalene, Swartz Marvin, Thielman Nathan, Mugavero Michael J
机构信息
Health Inequalities Program, Duke University, Center for Health Policy, Duke University, Durham, NC 27708, USA.
出版信息
South Med J. 2007 Nov;100(11):1114-22. doi: 10.1097/01.smj.0000286756.54607.9f.
BACKGROUND
The HIV/AIDS epidemic in the U.S. South is undergoing a marked shift toward a greater proportion of new HIV/AIDS cases in women, African-Americans, and through heterosexual transmission.
METHODS
Using consecutive sampling, 611 participants were interviewed from eight Infectious Diseases clinics in five southeastern states in 2001 to 2002.
RESULTS
Sixty four percent of participants were African-American, 31% were female, and 43% acquired HIV through heterosexual sex; 25% had private health insurance. Eighty-one percent were on antiretroviral therapy, and 46% had HIV RNA viral loads (VL) <400. Women and racial/ethnic minorities were less likely to be on antiretrovirals and to have VL <400. Probable psychiatric disorders (54%) and history of childhood sexual (30%) and physical abuse (21%) were common.
CONCLUSIONS
Prevention and care systems need to address the HIV epidemic's shift into poor, minority, and female populations. High levels of trauma and probable psychiatric disorders indicate a need to assess for and address these conditions in HIV clinical care.
背景
美国南部的艾滋病毒/艾滋病流行正在经历显著转变，女性、非裔美国人以及通过异性传播感染艾滋病毒/艾滋病的新病例所占比例越来越大。
方法
2001年至2002年期间，采用连续抽样法，对来自东南部五个州八家传染病诊所的611名参与者进行了访谈。
结果
64%的参与者为非裔美国人，31%为女性，43%通过异性性行为感染艾滋病毒；25%拥有私人医疗保险。81%的人正在接受抗逆转录病毒治疗，46%的人艾滋病毒RNA病毒载量（VL）<400。女性以及少数族裔接受抗逆转录病毒治疗且病毒载量<400的可能性较小。可能患有精神疾病（54%）以及有童年性虐待史（30%）和身体虐待史（21%）的情况很常见。
结论
预防和护理系统需要应对艾滋病毒流行向贫困人群、少数族裔和女性人群转移的情况。高水平的创伤和可能存在的精神疾病表明，有必要在艾滋病毒临床护理中评估并处理这些情况。
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