Reed Elizabeth, Myers Bronwyn, Novak Scott P, Browne Felicia A, Wechsberg Wendee M
Division of Global Public Health, School of Medicine, University of California, San Diego, 9500 Gilman Drive, Mail code 0507, La Jolla, CA, 92093, USA,
AIDS Behav. 2015 Jan;19(1):192-8. doi: 10.1007/s10461-014-0820-1.
Drug abuse is a contributing factor in women's HIV risk in low-income communities in Cape Town, South Africa. This study assessed whether experiencing violence is associated with reduced drug abstinence among adult women (n = 603) participating in a randomized field trial for an HIV prevention study in Cape Town. In relation to drug abstinence at 12-month follow-up, multivariable regression models were used to assess (1) baseline partner and non-partner victimization, and (2) victimization at 12-month follow-up among participants reporting baseline victimization. Baseline partner (AOR = 0.6; 95 % CI 0.4-0.9) and non-partner victimization (AOR = 0.6; 95 % CI 0.4-0.9) were associated with a reduced likelihood of drug abstinence at follow-up. Among participants who reported victimization at baseline, those no longer reporting victimization at follow-up did not differ significantly in drug abstinence compared with those who reported victimization at follow-up. The study findings highlight the lasting impact of victimization on women's drug use outcomes, persisting regardless of whether violence was no longer reported at follow-up. Overall, the findings support the need for the primary prevention of violence to address the cycle of violence, drug use, and HIV among women in this setting.
药物滥用是南非开普敦低收入社区女性感染艾滋病毒风险的一个促成因素。本研究评估了遭受暴力是否与参与开普敦一项艾滋病毒预防研究随机现场试验的成年女性（n = 603）药物戒断率降低有关。关于12个月随访时的药物戒断情况，使用多变量回归模型评估（1）基线时伴侣及非伴侣暴力侵害情况，以及（2）报告基线时遭受暴力侵害的参与者在12个月随访时的暴力侵害情况。基线时伴侣暴力侵害（调整后比值比[AOR]=0.6；95%置信区间[CI] 0.4 - 0.9）和非伴侣暴力侵害（AOR = 0.6；95% CI 0.4 - 0.9）与随访时药物戒断可能性降低有关。在基线时报告遭受暴力侵害的参与者中，随访时不再报告遭受暴力侵害的参与者与随访时报告遭受暴力侵害的参与者在药物戒断方面无显著差异。研究结果突出了暴力侵害对女性药物使用结果的持久影响，无论随访时是否不再报告暴力侵害情况，这种影响都持续存在。总体而言，研究结果支持开展暴力初级预防以解决该环境下女性暴力、药物使用和艾滋病毒循环问题的必要性。
