Quinn Katherine, Voisin Dexter R, Bouris Alida, Schneider John
a Center for AIDS Intervention Research, Department of Psychiatry and Behavioral Medicine , Medical College of Wisconsin , Milwaukee , WI , USA.
b School of Social Service Administration , University of Chicago , Chicago , IL , USA.
AIDS Care. 2016 Jul;28(7):866-72. doi: 10.1080/09540121.2016.1153596. Epub 2016 Feb 26.
In the USA, Black males are disproportionately affected by community violence and HIV. The aim of this study was to assess whether exposures to community violence are related to psychological distress, drug use, sexual risk behaviors, and medication adherence among a sample of HIV-positive young Black men who had sex with men (YBMSM). Data are from 98 YBMSM ages 18-29 years recruited from Chicago who completed measures on demographics, exposures to community violence, psychological distress, drug use, condomless anal intercourse, and medication adherence. Rates of exposure to community violence were high and youth reported victimization and witnessing numerous types of violence in their lifetime. In adjusted logistic regression analyses, models indicate that YBMSM reporting higher levels of exposure to community violence had significantly higher rates of condomless anal intercourse in the previous 6 months (AOR: 5.33, 95%CI: 1.38-20.55). Additionally, exposure to community violence was positively associated with psychological distress, hard drug use, and use of marijuana as a sex drug. Adherence to HIV antiretroviral medication was negatively associated with community violence (AOR: 0.36, 95%CI: 0.13-0.97). Rates of exposure to community violence are especially high in urban communities. Overall findings suggest that treatment, intervention, and programmatic approaches that include initiatives to address exposure to community violence might correlate with better health-related outcomes for HIV-positive YBMSM.
在美国，黑人男性受社区暴力和艾滋病毒的影响尤为严重。本研究的目的是评估社区暴力暴露是否与男男性行为的艾滋病毒阳性年轻黑人男性（YBMSM）样本中的心理困扰、药物使用、性风险行为和药物依从性有关。数据来自从芝加哥招募的98名年龄在18至29岁之间的YBMSM，他们完成了关于人口统计学、社区暴力暴露、心理困扰、药物使用、无保护肛交和药物依从性的测量。社区暴力暴露率很高，年轻人报告称在他们的一生中曾遭受过暴力侵害并目睹过多种类型的暴力。在调整后的逻辑回归分析中，模型表明，报告社区暴力暴露水平较高的YBMSM在过去6个月内无保护肛交的发生率显著更高（调整后的比值比：5.33，95%置信区间：1.38 - 20.55）。此外，社区暴力暴露与心理困扰、使用硬性毒品以及将大麻用作性刺激药物呈正相关。艾滋病毒抗逆转录病毒药物的依从性与社区暴力呈负相关（调整后的比值比：0.36，95%置信区间：0.13 - 0.97）。社区暴力暴露率在城市社区尤其高。总体研究结果表明，包括解决社区暴力暴露问题的举措在内的治疗、干预和项目方法可能与艾滋病毒阳性YBMSM更好的健康相关结果相关。
