aProgram in Public Health and Department of Family, Population and Preventive Medicine, Stony Brook University (State University of New York), Stony Brook, New York bDepartment of Sociology and Population Studies Center, University of Pennsylvania, Philadelphia, Pennsylvania, USA.
AIDS. 2019 Nov 15;33(14):2245-2250. doi: 10.1097/QAD.0000000000002352.
To investigate whether adverse childhood experiences are important determinants of sexual debut and HIV testing.
Adolescents (age 10-16; N = 2089) from rural Malawi were interviewed in 2017-2018 for the baseline wave of a longitudinal study of childhood adversity and HIV risk.
Respondents were interviewed in their local language. Surveys captured 13 lifetime childhood adversities (using the Adverse Childhood Experience - International Questionnaire); sexual debut; and previous HIV testing. We used multivariate regression models to test whether adversity, measured both cumulatively and separately, predicted HIV risk.
For each additional adversity, there was a significant rise in the odds of sexual debut (odds ratio 1.13, confidence interval 1.07-1.20) and HIV testing (odds ratio 1.10, confidence interval 1.04-1.16).
Preventing HIV among all young people necessitates a paradigm shift that recognizes the importance of early life social determinants in structuring HIV risk.
探究童年逆境是否是性初体验和 HIV 检测的重要决定因素。
2017-2018 年，我们对马拉维农村地区的青少年（年龄 10-16 岁；N=2089）进行了访谈，作为一项关于童年逆境与 HIV 风险的纵向研究的基线波。
受访者以当地语言接受访谈。调查记录了 13 项终身童年逆境（使用《国际逆境童年经历问卷》）；性初体验；以及之前的 HIV 检测。我们使用多变量回归模型来检验逆境（累积和单独测量）是否预测 HIV 风险。
每增加一项逆境，性初体验的几率（优势比 1.13，置信区间 1.07-1.20）和 HIV 检测的几率（优势比 1.10，置信区间 1.04-1.16）都会显著上升。
预防所有年轻人感染 HIV 需要一种范式转变，认识到早期生活社会决定因素在构建 HIV 风险方面的重要性。
