Willie Tiara, Kershaw Trace, Campbell Jacquelyn C, Alexander Kamila A
Center for Interdisciplinary Research on AIDS, Yale University, New Haven, USA.
Division of Social and Behavioral Sciences, Yale School of Public Health, New Haven, USA.
AIDS Behav. 2017 Aug;21(8):2261-2269. doi: 10.1007/s10461-017-1767-9.
A few studies suggest that women who experience intimate partner violence (IPV) are willing to use pre-exposure prophylaxis (PrEP), but no research has examined mediators of this relationship. The current study used path analysis to examine a phenomenon closely associated with IPV: reproductive coercion, or explicit male behaviors to promote pregnancy of a female partner without her knowledge or against her will. Birth control sabotage and pregnancy coercion-two subtypes of reproductive coercion behaviors-were examined as mediators of the relationship between IPV and PrEP acceptability among a cohort of 147 Black women 18-25 years of age recruited from community-based organizations in an urban city. IPV experiences were indirectly related to PrEP acceptability through birth control sabotage (indirect effect = 0.08; p < 0.05), but not to pregnancy coercion. Findings illustrate the importance of identifying and addressing reproductive coercion when assessing whether PrEP is clinically appropriate and a viable option to prevent HIV among women who experience IPV.
一些研究表明，遭受亲密伴侣暴力（IPV）的女性愿意使用暴露前预防（PrEP），但尚无研究探讨这种关系的中介因素。当前的研究采用路径分析来考察一种与亲密伴侣暴力密切相关的现象：生殖胁迫，即男性明确做出的在女性伴侣不知情或违背其意愿的情况下促使其怀孕的行为。在从一个城市的社区组织招募的147名18至25岁的黑人女性队列中，考察了节育破坏和怀孕胁迫（生殖胁迫行为的两种亚型）作为亲密伴侣暴力与PrEP可接受性之间关系的中介因素。亲密伴侣暴力经历通过节育破坏与PrEP可接受性间接相关（间接效应=0.08；p<0.05），但与怀孕胁迫无关。研究结果表明，在评估PrEP在临床上是否合适以及对于遭受亲密伴侣暴力的女性预防艾滋病毒是否是一个可行选择时，识别和解决生殖胁迫问题具有重要意义。
