Li Ying, Marshall Caitlin M, Rees Hilary C, Nunez Annabelle, Ezeanolue Echezona E, Ehiri John E
Department of Social Medicine & Health Service Management, Third Military Medical University, Chongqing, China; Division of Health Promotion Sciences/Global Health Institute, Mel & Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ, USA.
Division of Health Promotion Sciences/Global Health Institute, Mel & Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ, USA.
J Int AIDS Soc. 2014 Feb 13;17(1):18845. doi: 10.7448/IAS.17.1.18845. eCollection 2014.
To assess evidence of an association between intimate partner violence (IPV) and HIV infection among women.
Medline/PubMed, Embase, Web of Science, EBSCO, Ovid, Cochrane HIV/AIDS Group's Specialized Register and Cochrane Central Register of Controlled Trials were searched up to 20 May 2013 to identify studies that examined the association between IPV and HIV infection in women. We included studies on women aged ≥15 years, in any form of sexually intimate relationship with a male partner.
Twenty-eight studies [(19 cross-sectional, 5 cohorts and 4 case-control studies) involving 331,468 individuals in 16 countries - the US (eight studies), South Africa (four studies), East Africa (10 studies), India (three studies), Brazil (one study) and multiple low-income countries (two studies)] were included. Results were pooled using RevMan 5.0. To moderate effect estimates, we analyzed all data using the random effects model, irrespective of heterogeneity level. Pooled results of cohort studies indicated that physical IPV [pooled RR (95% CI): 1.22 (1.01, 1.46)] and any type of IPV [pooled RR (95% CI): 1.28 (1.00, 1.64)] were significantly associated with HIV infection among women. Results of cross-sectional studies demonstrated significant associations of physical IPV with HIV infection among women [pooled OR (95% CI): 1.44 (1.10, 1.87)]. Similarly, results of cross-sectional studies indicated that combination of physical and sexual IPV [pooled OR (95% CI): 2.00 (1.24, 3.22) and any type of IPV [pooled OR (95% CI): 1.41 (1.16, 1.73)] were significantly associated with HIV infection among women.
Available evidence suggests a moderate statistically significant association between IPV and HIV infection among women. To further elucidate the strength of the association between IPV and HIV infection among women, there is a need for high-quality follow-up studies conducted in different geographical regions of the world, and among individuals of diverse racial/cultural backgrounds and varying levels of HIV risks.
评估亲密伴侣暴力（IPV）与女性感染艾滋病毒之间关联的证据。
检索了截至2013年5月20日的Medline/PubMed、Embase、Web of Science、EBSCO、Ovid、Cochrane艾滋病毒/艾滋病小组的专门登记册以及Cochrane对照试验中央登记册，以确定研究IPV与女性艾滋病毒感染之间关联的研究。我们纳入了年龄≥15岁、与男性伴侣保持任何形式性亲密关系的女性研究。
纳入了28项研究[（19项横断面研究、5项队列研究和4项病例对照研究），涉及16个国家的331468人——美国（8项研究）、南非（4项研究）、东非（10项研究）、印度（3项研究）、巴西（1项研究）和多个低收入国家（2项研究）]。使用RevMan 5.0对结果进行汇总。为了得到适度的效应估计值，无论异质性水平如何，我们都使用随机效应模型分析所有数据。队列研究的汇总结果表明，身体暴力形式的亲密伴侣暴力[汇总相对危险度（95%置信区间）：1.22（1.01，1.46）]和任何类型的亲密伴侣暴力[汇总相对危险度（95%置信区间）：1.28（1.00，1.64）]与女性感染艾滋病毒显著相关。横断面研究结果表明，身体暴力形式的亲密伴侣暴力与女性感染艾滋病毒之间存在显著关联[汇总比值比（95%置信区间）：1.44（1.10，1.87）]。同样，横断面研究结果表明，身体暴力和性暴力相结合的亲密伴侣暴力形式[汇总比值比（95%置信区间）：2.00（1.24，3.22）]和任何类型的亲密伴侣暴力[汇总比值比（95%置信区间）：1.41（1.16，1.73）]与女性感染艾滋病毒显著相关。
现有证据表明亲密伴侣暴力与女性感染艾滋病毒之间存在中度统计学显著关联。为了进一步阐明亲密伴侣暴力与女性感染艾滋病毒之间关联的强度，需要在世界不同地理区域、不同种族/文化背景以及不同艾滋病毒风险水平的个体中开展高质量的随访研究。
