在一家市中心的 HIV 诊所中,针对 HIV 阳性妇女的亲密伴侣暴力行为的临床和心理健康相关性及其危险因素。
Clinical and mental health correlates and risk factors for intimate partner violence among HIV-positive women in an inner-city HIV clinic.
机构信息
The Johns Hopkins Urban Health Institute, Johns Hopkins Bloomberg School of Public Health, Maryland.
出版信息
Womens Health Issues. 2012 Nov-Dec;22(6):e563-9. doi: 10.1016/j.whi.2012.07.007. Epub 2012 Aug 30.
BACKGROUND
Intimate partner violence (IPV) is a serious health concern for women in the United States, and HIV-positive women experience more frequent and severe abuse compared with HIV-negative women. The goals of this study were to determine the prevalence of IPV among HIV-infected women receiving care in an urban clinic and to determine the HIV clinical and mental health correlates of IPV among HIV-positive women.
METHODS
We conducted a cross-sectional survey among 196 women visiting an inner-city HIV clinic. Women were eligible if they were 18 years of age or older, English speaking, and received both HIV primary and gynecologic care at the clinic. The survey queried demographics, drug and alcohol history, depressive symptoms, and IPV, using the Partner Violence Scale. Antiretroviral therapy (ART), CD4 cell count, HIV-1 RNA level, and appointment adherence were abstracted from clinical records.
FINDINGS
Overall, 26.5% of women reported experiencing IPV in the past year. There were no differences in sociodemographics, substance use, ART prescription, CD4 count, or HIV-1 RNA level between women who experienced IPV and those who had not. Women with mild and severe depressive symptoms were significantly more likely to report IPV compared with those without, with adjusted odds ratios of 3.4 and 5.5, respectively. Women who missed gynecologic appointments were 1.9 times more likely to report experiencing IPV.
CONCLUSIONS
IPV is prevalent among women presenting for HIV care, and depressive symptoms or missed gynecologic appointments should prompt further screening for IPV.
背景
亲密伴侣暴力(IPV)是美国女性面临的严重健康问题,与 HIV 阴性女性相比,HIV 阳性女性遭受的虐待更为频繁和严重。本研究旨在确定在城市诊所接受治疗的 HIV 感染女性中 IPV 的流行情况,并确定 HIV 阳性女性中 IPV 与 HIV 临床和心理健康的相关性。
方法
我们对 196 名在市中心 HIV 诊所就诊的女性进行了横断面调查。如果女性年龄在 18 岁或以上,会说英语,并且在诊所同时接受 HIV 初级保健和妇科保健,那么她们就有资格参加调查。调查使用伴侣暴力量表询问了人口统计学、药物和酒精使用史、抑郁症状和 IPV 情况。从临床记录中提取了抗逆转录病毒治疗(ART)、CD4 细胞计数、HIV-1 RNA 水平和预约依从性。
结果
总体而言,26.5%的女性报告在过去一年中经历过 IPV。经历过 IPV 的女性和没有经历过 IPV 的女性在社会人口统计学、药物使用、ART 处方、CD4 计数或 HIV-1 RNA 水平方面没有差异。有轻度和重度抑郁症状的女性报告 IPV 的可能性明显高于没有抑郁症状的女性,调整后的优势比分别为 3.4 和 5.5。错过妇科预约的女性报告经历过 IPV 的可能性是未错过预约的女性的 1.9 倍。
结论
在接受 HIV 护理的女性中,IPV 很普遍,抑郁症状或错过妇科预约应该提示进一步筛查 IPV。