美国6个城市男男性行为黑人中儿童期性虐待、亲密伴侣暴力及抑郁与艾滋病毒风险因素的关系。
Relation of Childhood Sexual Abuse, Intimate Partner Violence, and Depression to Risk Factors for HIV Among Black Men Who Have Sex With Men in 6 US Cities.
作者信息
Williams John K, Wilton Leo, Magnus Manya, Wang Lei, Wang Jing, Dyer Typhanye Penniman, Koblin Beryl A, Hucks-Ortiz Christopher, Fields Sheldon D, Shoptaw Steve, Stephenson Rob, O'Cleirigh Conall, Cummings Vanessa
机构信息
John K. Williams is with the Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles (UCLA). Leo Wilton is with College of Community and Public Affairs, Department of Human Development, Binghamton University, Binghamton, NY. Manya Magnus is with the Milken Institute School of Public Health, Department of Epidemiology and Biostatistics, George Washington University, Washington, DC. Lei Wang and Jing Wang are with the Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Research Center, Seattle, WA. Typhanye Penniman Dyer is with the Department of Epidemiology and Biostatistics, University of Maryland, College Park. Beryl A. Koblin is with New York Blood Center, Laboratory of Infectious Disease Prevention, New York, NY. Christopher Hucks-Ortiz is with the Department of Family Medicine, UCLA. Sheldon D. Fields is with the Nicole Wertheim College of Nursing and Health Sciences, Florida International University, Miami. Steve Shoptaw is with the departments of Family Medicine and Psychiatry and Biobehavioral Sciences, UCLA. Rob Stephenson is with the Rollins School of Public Health, Emory University, Atlanta, GA. Conall O'Cleirigh is with Fenway Institute HIV Clinical Research Support (CRS), Fenway Community Health Center, Boston, MA. Vanessa Cummings is with the Department of Pathology, Johns Hopkins School of Medicine, Baltimore, MD.
出版信息
Am J Public Health. 2015 Dec;105(12):2473-81. doi: 10.2105/AJPH.2015.302878. Epub 2015 Oct 15.
OBJECTIVES
We assessed the relation of childhood sexual abuse (CSA), intimate partner violence (IPV), and depression to HIV sexual risk behaviors among Black men who have sex with men (MSM).
METHODS
Participants were 1522 Black MSM recruited from 6 US cities between July 2009 and December 2011. Univariate and multivariable logistic regression models were used.
RESULTS
Participants reported sex before age 12 years with someone at least 5 years older (31.1%), unwanted sex when aged 12 to 16 years (30%), IPV (51.8%), and depression (43.8%). Experiencing CSA when aged 12 to 16 years was inversely associated with any receptive condomless anal sex with a male partner (adjusted odds ratio [AOR] = 0.50; 95% confidence interval [CI] = 0.29, 0.86). Pressured or forced sex was positively associated with any receptive anal sex (AOR = 2.24; 95% CI = 1.57, 3.20). Experiencing CSA when younger than 12 years, physical abuse, emotional abuse, having been stalked, and pressured or forced sex were positively associated with having more than 3 male partners in the past 6 months. Among HIV-positive MSM (n = 337), CSA between ages 12 and 16 years was positively associated with having more than 3 male partners in the past 6 months.
CONCLUSIONS
Rates of CSA, IPV, and depression were high, but associations with HIV sexual risk outcomes were modest.
目的
我们评估了童年性虐待（CSA）、亲密伴侣暴力（IPV）和抑郁与男男性行为者（MSM）中的黑人男性感染HIV的性风险行为之间的关系。
方法
参与者为2009年7月至2011年12月期间从美国6个城市招募的1522名黑人男男性行为者。使用单变量和多变量逻辑回归模型。
结果
参与者报告在12岁之前与至少大5岁的人发生过性行为（31.1%），在12至16岁时发生过非自愿性行为（30%），经历过亲密伴侣暴力（51.8%），以及患有抑郁症（43.8%）。12至16岁时经历童年性虐待与与男性伴侣发生任何无保护被动肛交呈负相关（调整后的优势比[AOR]=0.50；95%置信区间[CI]=0.29，0.86）。被迫或强迫性行为与任何被动肛交呈正相关（AOR=2.24；95%CI=1.57，3.20）。12岁之前经历童年性虐待、身体虐待、情感虐待、被跟踪以及被迫或强迫性行为与在过去6个月内有超过3个男性伴侣呈正相关。在HIV阳性的男男性行为者（n=337）中，12至16岁时的童年性虐待与在过去6个月内有超过3个男性伴侣呈正相关。
结论
童年性虐待、亲密伴侣暴力和抑郁的发生率很高，但与HIV性风险结果的关联程度适中。
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