Wang Xuetao, Salters Kate A, Zhang Wen, McCandless Lawrence, Money Deborah, Pick Neora, Montaner Julio S G, Hogg Robert S, Kaida Angela
Faculty of Health Sciences, Simon Fraser University, 8888 University Drive, Burnaby, BC, Canada V5A 1S6.
AIDS Res Treat. 2012;2012:560361. doi: 10.1155/2012/560361. Epub 2012 Nov 26.
Background. HIV-infected women are disproportionately burdened by gynaecological complications, psychological disorders, and certain sexually transmitted infections that may not be adequately addressed by HIV-specific care. We estimate the prevalence and covariates of women's health care (WHC) utilization among harder-to-reach, treatment-experienced HIV-infected women in British Columbia (BC), Canada. Methods. We used survey data from 231 HIV-infected, treatment-experienced women enrolled in the Longitudinal Investigations into Supportive and Ancillary Health Services (LISA) study, which recruited harder-to-reach populations, including aboriginal people and individuals using injection drugs. Independent covariates of interest included sociodemographic, psychosocial, behavioural, individual health status, structural factors, and HIV clinical variables. Logistic regression was used to generate adjusted estimates of associations between use of WHC and covariates of interest. Results. Overall, 77% of women reported regularly utilizing WHC. WHC utilization varied significantly by region of residence (P value <0.01). In addition, women with lower annual income (AOR (95% CI) = 0.14 (0.04-0.54)), who used illicit drugs (AOR (95% CI) = 0.42 (0.19-0.92)) and who had lower provider trust (AOR (95% CI) = 0.97 (0.95-0.99)), were significantly less likely to report using WHC. Conclusion. A health service gap exists along geographical and social axes for harder-to-reach HIV-infected women in BC. Women-centered WHC and HIV-specific care should be streamlined and integrated to better address women's holistic health.
背景。感染艾滋病毒的女性承受着不成比例的妇科并发症、心理障碍以及某些性传播感染的负担，而针对艾滋病毒的护理可能无法充分解决这些问题。我们估计了加拿大不列颠哥伦比亚省（BC）难以接触到、有治疗经验的感染艾滋病毒女性中妇女保健（WHC）利用情况的患病率及相关因素。方法。我们使用了参与支持性和辅助性健康服务纵向调查（LISA）研究的231名有治疗经验的感染艾滋病毒女性的调查数据，该研究招募了包括原住民和注射吸毒者在内的难以接触到的人群。感兴趣的独立相关因素包括社会人口统计学、心理社会、行为、个人健康状况、结构因素以及艾滋病毒临床变量。使用逻辑回归来生成WHC使用与感兴趣的相关因素之间关联的调整估计值。结果。总体而言，77%的女性报告定期使用WHC。WHC的使用情况因居住地区而异，差异有统计学意义（P值<0.01）。此外，年收入较低的女性（调整后比值比（AOR）（95%置信区间）=0.14（0.04 - 0.54））、使用非法药物的女性（AOR（95%置信区间）=0.42（0.19 - 0.92））以及对医疗服务提供者信任度较低的女性（AOR（95%置信区间）=0.97（0.95 - 0.99））报告使用WHC的可能性显著较低。结论。对于BC省难以接触到的感染艾滋病毒女性，在地理和社会层面存在健康服务差距。应以女性为中心的WHC和针对艾滋病毒的护理应进行简化和整合，以更好地解决女性的整体健康问题。
