性工作作为墨西哥提华纳注射吸毒者中女性性别与艾滋病感染之间的中介
Sex Work as a Mediator Between Female Gender and Incident HIV Infection Among People Who Inject Drugs in Tijuana, Mexico.
机构信息
School of Medicine, University of California, San Diego, La Jolla, USA.
School of Medicine, University of California, San Francisco, San Francisco, USA.
出版信息
AIDS Behav. 2020 Sep;24(9):2720-2731. doi: 10.1007/s10461-020-02828-y.
We studied mechanisms driving gender differences in HIV incidence among 651 women and men who inject drugs (PWID) in Tijuana, Mexico, hypothesizing that sex work will mediate the association between female gender and HIV incidence. Of 43 HIV seroconversions occurring between 2011 and 2018, 8.8% were among females and 5.2% among males. HIV incidence density was significantly higher among females versus males (1.75 per 100 person years [PY], 95% CI 1.16-2.66, vs. 0.95 per 100 PY, 95% CI 0.62-1.47). Factors significantly associated with HIV seroconversion were: sex work (adjusted hazard ratio [aHR] = 2.25, 95% CI 1.05-4.80); methamphetamine injection (aHR = 2.30, 95% CI 1.12-4.73); and methamphetamine and heroin co-injection in the past six months (aHR = 2.26, 95% CI 1.23-4.15). In mediation analyses, sex work mediated a substantial proportion (84.3%) of the association between female gender and HIV incidence. Interventions should target female PWID who engage in sex work to reduce gender-related disparities in HIV incidence.
我们研究了在墨西哥提华纳的 651 名注射毒品的男女（PWID）中导致 HIV 发病率性别差异的机制，假设性工作将调节女性性别和 HIV 发病率之间的关联。在 2011 年至 2018 年期间发生的 43 例 HIV 血清转换中，8.8%发生在女性中，5.2%发生在男性中。女性的 HIV 发病率密度明显高于男性（1.75 人年/100 人，95%CI 1.16-2.66，而男性为 0.95 人年/100 人，95%CI 0.62-1.47）。与 HIV 血清转换显著相关的因素是：性工作（调整后的危险比[aHR] = 2.25，95%CI 1.05-4.80）；冰毒注射（aHR = 2.30，95%CI 1.12-4.73）；以及过去六个月内冰毒和海洛因共同注射（aHR = 2.26，95%CI 1.23-4.15）。在中介分析中，性工作者在女性性别和 HIV 发病率之间的关联中解释了相当大的比例（84.3%）。干预措施应针对从事性工作的女性 PWID，以减少与性别相关的 HIV 发病率差异。
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