Turner Alezandria K, Jones Kandice C, Rudolph Abby, Rivera Alexis V, Crawford Natalie, Lewis Crystal Fuller
Department of Epidemiology, Columbia Mailman School of Public Health, 722 W 168th St, New York, NY, 10032, USA,
J Urban Health. 2014 Oct;91(5):957-68. doi: 10.1007/s11524-014-9902-7.
Physical victimization has been linked to high-risk sexual partnerships in women. Although illicit drug-using heterosexual men are at high-risk of physical victimization, the association between violence and high-risk partners in heterosexual men has received little attention in the published literature. We examined the association between experience of severe physical victimization and acquisition of a high-risk sexual partner (i.e., a partner who injected drugs or participated in transactional sex) 1 year later among illicit drug-using men in New York City (2006-2009) using secondary cross-sectional data. Injection and non-injection drug-using men (n = 280) provided a retrospectively recalled history of risk behavior and violence for each year over the past 4 years. Our primary outcome was acquisition of a high-risk sexual partner in any year following the baseline year. Our primary exposure was severe physical victimization (i.e., threatened with a knife or gun, beaten up, shot, or stabbed) in the prior year. Frequency of cocaine, heroin, and crack use and sexual victimization were also assessed. Log-binomial logistic regression with generalized estimating equation (GEE) methods was used to account for repeated measures for up to four time points. After adjustment for important covariates, participants that experienced physical victimization were significantly more likely to have acquired a high-risk sexual partner 1 year later (relative risk (RR), 3.73; 95 % confidence interval (CI), 1.55-8.97). Our study challenges gender-based stereotypes surrounding physical victimization and provides support for multidisciplinary programs that address both violence and HIV risk among illicit drug-using heterosexual men.
身体伤害与女性的高风险性行为伴侣有关。尽管吸食非法毒品的异性恋男性面临身体伤害的高风险,但暴力与异性恋男性高风险伴侣之间的关联在已发表的文献中很少受到关注。我们利用二次横断面数据,研究了纽约市(2006 - 2009年)吸食非法毒品男性中,严重身体伤害经历与1年后获得高风险性行为伴侣(即注射毒品或参与交易性性行为的伴侣)之间的关联。注射毒品和不注射毒品的男性(n = 280)回顾性地提供了过去4年中每年的风险行为和暴力史。我们的主要结局是在基线年份后的任何一年获得高风险性行为伴侣。我们的主要暴露因素是上一年遭受的严重身体伤害(即受到刀或枪威胁、被殴打、枪击或刺伤)。还评估了可卡因、海洛因和快克的使用频率以及性伤害情况。采用广义估计方程(GEE)方法的对数二项逻辑回归用于处理多达四个时间点的重复测量。在对重要协变量进行调整后,经历身体伤害的参与者在1年后获得高风险性行为伴侣的可能性显著更高(相对风险(RR),3.73;95%置信区间(CI),1.55 - 8.97)。我们的研究挑战了围绕身体伤害的基于性别的刻板印象,并为解决吸食非法毒品的异性恋男性中的暴力和艾滋病毒风险的多学科项目提供了支持。