Center on Gender Equity and Health, University of California San Diego, San Diego, CA, USA.
Division of Infectious Diseases and Global Public Health, Department of Medicine, University of California, San Diego, 9500 Gilman Drive, MC 0507, La Jolla, CA, 92093-0507, USA.
AIDS Behav. 2018 Sep;22(9):2830-2839. doi: 10.1007/s10461-018-2149-7.
Among persons who inject drugs, women have a higher HIV prevalence (than men) in many settings. Understanding how gender affects risk for infection among HIV-negative, and transmission among HIV-positive people who currently or previously injected drugs is key to designing effective prevention and treatment programs. We analyzed data from 291 persons living with HIV who had ever injected drugs. Participants were drawn from the Russia Alcohol Research Collaboration on HIV/AIDS cohort (2012-2015) to examine associations between female gender and HIV transmission risk. Primary outcomes were sharing drug injecting equipment (e.g., needle/syringes) and condomless sex. Secondary outcomes were alcohol use before sharing drug injecting equipment; before condomless sex; and both sharing drug injecting equipment and condomless sex. Logistic regression models assessed associations between gender and outcomes, controlling for demographics, partner HIV status and use of antiretroviral treatment. Female gender was not significantly associated with sharing drug injecting equipment [aOR = 1.45, 95% confidence interval (CI) 0.85-2.46, p value = 0.18] but was associated with condomless sex (aOR = 1.91, 95% CI 1.12-3.23, p = 0.02) in adjusted models. Female gender was not significantly associated with any secondary outcomes. Better understanding of risky sex and drug use behaviors among people who currently or previously injected drugs can support the design of effective gender-tailored HIV prevention interventions.
在许多情况下，与男性相比，注射毒品的人群中女性的 HIV 感染率更高。了解性别如何影响 HIV 阴性人群的感染风险，以及 HIV 阳性人群目前或曾经注射毒品的传播风险，是设计有效预防和治疗方案的关键。我们分析了 291 名曾经注射过毒品的 HIV 感染者的数据。参与者来自俄罗斯酒精研究合作组织的 HIV/AIDS 队列（2012-2015 年），以研究女性性别与 HIV 传播风险之间的关联。主要结局是共用吸毒用具（例如，针/注射器）和无保护性行为。次要结局是在共用吸毒用具之前和无保护性行为之前饮酒；以及在共用吸毒用具和无保护性行为之前。逻辑回归模型评估了性别与结局之间的关联，控制了人口统计学特征、伴侣 HIV 状况和抗逆转录病毒治疗的使用情况。女性性别与共用吸毒用具之间没有显著关联（调整后的比值比[aOR] = 1.45，95%置信区间[CI] 0.85-2.46，p 值 = 0.18），但在调整后的模型中与无保护性行为有关（aOR = 1.91，95% CI 1.12-3.23，p = 0.02）。女性性别与任何次要结局均无显著关联。更好地了解当前或曾经注射毒品人群的危险性行为和吸毒行为，可以支持设计有效的针对性别的 HIV 预防干预措施。
