Latka Mary H, Mizuno Yuko, Wu YingFeng, Tobin Karin E, Metsch Lisa R, Frye Victoria, Gómez Cynthia A, Arnsten Julia H
Center for Urban Epidemiologic Studies, New York Academy of Medicine, New York, NY, USA.
J Acquir Immune Defic Syndr. 2007 Nov 1;46 Suppl 2:S88-95. doi: 10.1097/QAI.0b013e31815767b3.
We developed a scale among HIV-positive injection drug users (IDUs) to measure self-perceived responsibility to limit HIV transmission during sex. We describe the characteristics of HIV-positive IDUs (n=1114, 62% male, HIV-positive for 9 years on average) who felt responsible for protecting their sexual partners from HIV and evaluated whether such feelings were associated with safer sexual practices. Using this scale (Cronbach alpha=0.83) and audio computer-assisted self-interviewing technology, 75% of this sample felt responsible for protecting their sexual partners from HIV. In cross-sectional multivariate analysis, HIV-positive IDUs who felt responsible were those with greater HIV knowledge (adjusted odds ratio [95% confidence interval]: 1.74 [1.26 to 2.40]), perceived social support (1.77 [1.28 to 2.44]), self-efficacy for safely injecting (1.41 [1.02 to 1.94]), and self-efficacy for using condoms (1.92 [1.38 to 2.68]). Feeling responsible was associated with having relatively fewer sex partners (<10 vs. >or=10, 0.57 [0.34 to 0.96]) and a lower odds of unprotected sex (0.63 [0.45 to 0.89]) but was not associated with safer injection practices. Feelings of responsibility did not vary by demographic characteristics, suggesting that prevention messages that encourage HIV-positive people to play a role in curbing HIV transmission may be acceptable to many HIV-positive IDUs. Working with HIV-positive IDUs to increase or reinforce feelings of responsibility may reduce the sexual transmission of HIV.
我们为感染艾滋病毒的注射吸毒者（IDU）开发了一种量表，以衡量他们在性行为中自我感知的限制艾滋病毒传播的责任。我们描述了那些认为自己有责任保护其性伴侣免受艾滋病毒感染的艾滋病毒阳性注射吸毒者（n = 1114，62%为男性，平均感染艾滋病毒9年）的特征，并评估了这种责任感是否与更安全的性行为相关。使用该量表（克朗巴哈系数α = 0.83）和音频计算机辅助自我访谈技术，该样本中有75%的人认为自己有责任保护其性伴侣免受艾滋病毒感染。在横断面多变量分析中，有责任感的艾滋病毒阳性注射吸毒者具有更高的艾滋病毒知识水平（调整后的优势比[95%置信区间]：1.74[1.26至2.40]）、感知到的社会支持（1.77[1.28至2.44]）、安全注射的自我效能感（1.41[1.02至1.94]）以及使用避孕套的自我效能感（1.92[1.38至2.68]）。有责任感与性伴侣相对较少（<10个与≥10个相比，0.57[0.34至0.96]）以及无保护性行为的几率较低（0.63[0.45至0.89]）相关，但与更安全的注射行为无关。责任感不因人口统计学特征而有所不同，这表明鼓励艾滋病毒阳性者在遏制艾滋病毒传播中发挥作用的预防信息可能为许多艾滋病毒阳性注射吸毒者所接受。与艾滋病毒阳性注射吸毒者合作以增强或强化责任感可能会减少艾滋病毒的性传播。
