女性遭受强奸后 HIV 感染率上升。

Increase in HIV incidence in women exposed to rape.

机构信息

Gender and Health Research Unit, South African Medical Research Council.

Faculty of Health Sciences, School of Public Health and Family Medicine, University of Cape Town.

出版信息

AIDS. 2021 Mar 15;35(4):633-642. doi: 10.1097/QAD.0000000000002779.

DOI:10.1097/QAD.0000000000002779

PMID:33264114

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7924974/

Abstract

OBJECTIVE

To determine the incidence of HIV acquisition in women postrape compared with a cohort of women who had not been raped.

DESIGN

A prospective cohort study.

METHODS

The Rape Impact Cohort Evaluation study based in Durban, South Africa, enrolled women aged 16-40 years from postrape care services, and a control group of women from Primary Healthcare services. Women who were HIV negative at baseline (441 in the rape-exposed group and 578 in the control group) were followed for 12-36 months with assessments every 3 months in the first year and every 6 months thereafter. Multivariable Cox regression models adjusted for baseline and time varying covariates were used to investigate the effect of rape exposure on HIV incidence over follow-up.

RESULTS

Eighty-six women acquired HIV during 1605.5 total person-years of follow-up, with an incident rate of 6.6 per 100 person-years [95% confidence interval (CI): 4.8-9.1] among the rape exposed group and 4.7 per 100 person-years (95% CI: 3.5-6.2) among control group. After controlling for confounders (age, previous trauma, social support, perceived stress, multiple partners and transactional sex with a casual partner), women exposed to rape had a 60% increased risk of acquiring HIV [adjusted hazard ratio: 1.59 (95% CI: 1.01-2.48)] compared with those not exposed. Survival analysis showed difference in HIV incident occurred after month 9.

CONCLUSION

Rape is a long-term risk factor for HIV acquisition. Rape survivors need both immediate and long-term HIV prevention and care.

摘要

目的

确定强奸后女性获得艾滋病病毒（HIV）的感染率与未遭受强奸的女性队列进行比较。

设计

前瞻性队列研究。

方法

南非德班的强奸影响队列评估研究招募了来自强奸后护理服务的年龄在 16-40 岁之间的女性以及来自初级保健服务的对照组女性。在基线时 HIV 阴性的女性（暴露于强奸组 441 例，对照组 578 例）随访 12-36 个月，在第一年每 3 个月评估一次，此后每 6 个月评估一次。使用多变量 Cox 回归模型，根据基线和时间变化的协变量调整，以调查暴露于强奸对随访期间 HIV 发病率的影响。

结果

在 1605.5 人年的随访中，86 名女性感染了 HIV，感染率为每 100 人年 6.6 例（95%可信区间：4.8-9.1），暴露于强奸组为 6.6 例，对照组为 4.7 例（95%可信区间：3.5-6.2）。在控制了混杂因素（年龄、以前的创伤、社会支持、感知压力、多个伴侣和与偶然伴侣的交易性性行为）后，与未暴露于强奸的女性相比，暴露于强奸的女性感染 HIV 的风险增加了 60%（调整后的危险比：1.59[95%可信区间：1.01-2.48]）。生存分析显示，HIV 发病的差异发生在第 9 个月之后。