Centre for Evidence-Based Intervention, Department of Social Policy and Intervention, University of Oxford, Barnett House, 32 Wellington Square, Oxford, UK.
Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa.
AIDS Behav. 2018 Oct;22(10):3307-3323. doi: 10.1007/s10461-018-2186-2.
Women who inject drugs are disproportionately affected by HIV and intimate partner violence (IPV); however, the link between IPV and HIV remains under-researched among substance-using women in low- and middle-income countries. This study examined associations and additive effects of different forms of IPV victimization (psychological, physical and/or injurious, and sexual) on HIV sexual risk behavior among women who inject drugs in Indonesia. Respondent-driven sampling (RDS) was used to recruit 731 women from Greater Jakarta and Bandung, West Java. RDS-II weighted prevalence of any past-year IPV was 68.9% (95% CI 65.0, 72.6) in Jakarta and 55.9% (95% CI 48.0, 63.5) in Bandung. In separate logistic regressions controlling for socio-demographic covariates, all three forms of IPV showed statistically significant associations with sexual risk behavior. After adjusting for all IPV types, psychological (OR 1.87; 95% CI 1.17, 2.99; p = 0.009) and sexual (OR 1.98; 95% CI 1.22, 3.21; p = 0.006) IPV independently predicted women's sexual risk behavior. Marginal effects models suggested that co-occurrence of multiple forms of IPV had greater adverse consequences: sexual risk behavior was reported by 64.1% of women who did not experience any IPV, but increased to 89.9% among women exposed to all three types. Comprehensive harm reduction services that integrate IPV monitoring and prevention are urgently needed to reduce both HIV and IPV.
受艾滋病毒和亲密伴侣暴力（IPV）影响最大的是注射毒品的女性；然而，在中低收入国家，药物使用者中的女性，其 IPV 和艾滋病毒之间的联系仍然研究不足。本研究调查了印度尼西亚注射毒品女性中不同形式的 IPV 受害（心理、身体和/或伤害和性）与艾滋病毒性风险行为之间的关联和相加效应。采用响应驱动抽样（RDS）从雅加达和西爪哇万隆招募了 731 名女性。雅加达过去一年任何形式 IPV 的 RDS-II 加权患病率为 68.9%（95%CI 65.0，72.6），万隆为 55.9%（95%CI 48.0，63.5）。在分别控制社会人口统计学协变量的逻辑回归中，所有三种形式的 IPV 均与性风险行为呈统计学显著关联。在调整所有 IPV 类型后，心理（OR 1.87；95%CI 1.17，2.99；p=0.009）和性（OR 1.98；95%CI 1.22，3.21；p=0.006）的 IPV 独立预测了女性的性风险行为。边际效应模型表明，多种形式的 IPV 同时发生具有更大的不良后果：没有经历任何 IPV 的女性中，有 64.1%报告了性风险行为，但在经历了所有三种类型的女性中，这一比例增加到 89.9%。迫切需要综合减少伤害服务，将 IPV 监测和预防纳入其中，以减少艾滋病毒和 IPV 的发生。
