Division of Infectious Diseases and Global Public Health, Department of Medicine, School of Medicine, University of California San Diego, 9500 Gilman Drive, MC 0507, La Jolla, CA, 92093-0507, USA.
Hemophilia and Thrombosis Treatment Center, University of California San Diego, 9500 Gilman Drive, MC 0878, La Jolla, CA, 92093-0878, USA.
J Urban Health. 2020 Jun;97(3):387-394. doi: 10.1007/s11524-020-00435-9.
Methamphetamine use, sexual relationship power (SRP), and partner violence (PV) are associated with increased risk of sexually transmitted infections (STIs) among women. The objective of our study was to examine the association of recent PV and SRP on STIs by partner type among HIV-negative, heterosexual women who use methamphetamine in San Diego, CA. Using baseline survey data from 209 women enrolled in FASTLANE II, an HIV behavioral intervention trial, we conducted logistic regression analyses to examine associations between PV, SRP, and self-reported lifetime STIs (e.g., chlamydia, gonorrhea). Models focused on PV perpetrated within the past 2 months by: (1) spouse, live-in, or steady sexual partners and (2) casual or anonymous sexual partners. Seventy-eight percent of women reported lifetime physical PV and 57% reported lifetime sexual PV. In the past 2 months, 19.6% reported physical and/or sexual violence by a spouse, live-in, or steady sexual partner, and 7.2% reported physical and/or sexual PV by a casual or anonymous partner. Median SRP score was 2.36 (interquartile range: 2.02-2.68). Twenty-six percent of women reported ever being diagnosed with ≥ 1 STI. While recent physical violence and sexual violence were not associated with STI history among women in steady relationships, women who reported recent sexual violence by casual/anonymous partners were approximately 8 times more likely to ever have an STI compared with those with no history of recent PV by casual/anonymous partners (AOR: 7.70; 95% CI: 1.32, 44.84). SRP was not associated with lifetime STIs among women who reported either partner type. Our findings support a relationship between recent sexual violence perpetrated by casual/anonymous partners and women's STI history. Women who use methamphetamine need help in navigating partner violence experiences. Risk reduction interventions to support this marginalized population are needed.
甲基苯丙胺的使用、性关系权力（SRP）和伴侣暴力（PV）会增加女性感染性传播感染（STI）的风险。我们的研究目的是检查在加利福尼亚州圣地亚哥使用甲基苯丙胺的 HIV 阴性异性恋女性中，按伴侣类型分析近期 PV 和 SRP 与 STI 的关系。我们使用 FASTLANE II （HIV 行为干预试验）中招募的 209 名女性的基线调查数据，进行逻辑回归分析，以检查过去 2 个月内发生的 PV、SRP 与自我报告的终身性传播感染（如衣原体、淋病）之间的关系。模型重点关注过去 2 个月内由：（1）配偶、同居或稳定的性伴侣和（2）偶然或匿名性伴侣实施的 PV。78%的女性报告了终身身体 PV，57%的女性报告了终身性 PV。在过去的 2 个月中，19.6%的女性报告了来自配偶、同居或稳定性伴侣的身体和/或性暴力，7.2%的女性报告了来自偶然或匿名伴侣的身体和/或性暴力。SRP 的中位数评分为 2.36（四分位距：2.02-2.68）。26%的女性报告曾被诊断出患有≥1 种 STI。虽然在稳定关系中的女性中，近期的身体暴力和性暴力与 STI 史无关，但与没有近期偶然/匿名伴侣暴力史的女性相比，报告近期偶然/匿名伴侣性暴力的女性更有可能曾经患有 STI（AOR：7.70；95%CI：1.32，44.84）。在报告两种伴侣类型的女性中，SRP 与终身 STI 无关。我们的研究结果支持了偶然/匿名伴侣近期实施的性暴力与女性 STI 史之间的关系。使用甲基苯丙胺的女性需要帮助来应对伴侣暴力的经历。需要为这个边缘化群体提供减少风险的干预措施。
