“一切都取决于你认识谁”:多米尼加共和国感染艾滋病毒的女性性工作者的社交网络和毒品使用情况。
"Todo se trata de a quién conoces": Social Networks and Drug Use Among Female Sex Workers Living with HIV in the Dominican Republic.
机构信息
Department of Global Community Health and Behavioral Sciences, Tulane School of Public Health and Tropical Medicine, 1440 Canal Street, New Orleans, LA, 70112, USA.
La Universidad Autónoma de Santo Domingo, Santo Domingo, Dominican Republic.
出版信息
AIDS Behav. 2021 Apr;25(4):1276-1289. doi: 10.1007/s10461-020-03094-8. Epub 2020 Nov 17.
The purpose of this study was to characterize the social networks of female sex workers (FSWs) living with HIV in the Dominican Republic (DR) and to examine the association between daily drug use and network risk profile. The study employed a micro-longitudinal observational design using a 7-day mobile health (mHealth) daily diary to collect daily substance use behaviors and social network data was collected at study enrollment. A series of crude and adjusted modified log-Poisson repeated measures regression models with generalized estimating equations (GEE), clustering by individual with a compound symmetry working correlation structure were fit to estimate the relative risks and 95% confidence intervals. Controlling for individual level factors, findings revealed that FSWs with more network members who were drug users (≥ 3) and more network members who were sexual partners and also drugs users (≥ 2) were 8.89 (95% CI 2.62, 30.22) and 6.08 (95% CI 1.20, 30.92) times more likely to engage in daily drug use compared to women with small drug and sex and drug networks. Study findings demonstrate the role high risk networks have on risk behaviors. Results may be used to inform interventions that focus on modifying negative social ties, creating and/or improving existing positive support relationships, and integrating drug use harm reduction promotion within HIV treatment programs.
本研究旨在描绘多米尼加共和国(DR)艾滋病毒感染者女性性工作者(FSWs)的社交网络,并探究每日吸毒行为与网络风险特征之间的关联。本研究采用微纵向观察设计,通过为期 7 天的移动健康(mHealth)日常日记收集每日物质使用行为和社交网络数据,在研究开始时进行收集。使用具有广义估计方程(GEE)的复合对称工作相关结构的个体聚类的一系列未经调整和调整后的修正对数泊松重复测量回归模型,以估计相对风险和 95%置信区间。控制个体水平因素后,研究结果表明,与小毒品和性伴侣网络以及小毒品和性伴侣网络中吸毒者网络成员较少的女性相比,网络成员中吸毒者(≥3 人)和性伴侣及吸毒者(≥2 人)较多的 FSW 更有可能每日吸毒,其相对风险分别为 8.89(95%CI 2.62, 30.22)和 6.08(95%CI 1.20, 30.92)。研究结果表明,高危网络对风险行为具有影响。研究结果可用于为干预措施提供信息,干预措施的重点是改变负面社会关系、建立和/或改善现有的积极支持关系,并将毒品使用减少危害纳入 HIV 治疗方案。