Suzanne Dworak-Peck School of Social Work, University of Southern California, 669 West 34th St., Los Angeles, CA, 90089, USA.
Bashkir State Medical University, Ufa, Russia.
AIDS Behav. 2021 Jul;25(7):2120-2130. doi: 10.1007/s10461-020-03142-3. Epub 2021 Jan 1.
Violence experience has been consistently associated with HIV risks and substance use behaviors. Although many studies have focused on intimate partner violence (IPV), the role of violence at a structural level (i.e., police abuse) remains relevant for people who inject drugs. This study evaluated the association of IPV and police-perpetrated violence experiences with HIV risk behaviors and substance use in a cohort of HIV-positive people who inject drugs in Ukraine. We also evaluated possible moderation effects of gender and socioeconomic status in the links between violence exposure and HIV risk and polysubstance use behaviors. Data came from the Providence/Boston-CFAR-Ukraine Study involving 191 HIV-positive people who inject drugs conducted at seven addiction treatment facilities in Ukraine. Results from logistic regressions suggest that people who inject drugs and experienced IPV had higher odds of polysubstance use than those who did not experience IPV. Verbal violence and sexual violence perpetrated by police were associated with increased odds of inconsistent condom use. The odds of engaging in polysubstance use were lower for women in relation to police physical abuse. We found no evidence supporting socioeconomic status moderations. Violence experiences were associated with substance use and sexual HIV risk behaviors in this cohort of HIV-positive people who inject drugs in Ukraine. Trauma-informed prevention approaches that consider both individual and structural violence could improve this population's HIV risks.
暴力经历一直与 HIV 风险和物质使用行为相关。尽管许多研究都集中在亲密伴侣暴力(IPV)上,但在结构性层面上(即警察虐待)的暴力行为对注射毒品的人仍然具有重要意义。本研究评估了乌克兰一组 HIV 阳性注射毒品者的 IPV 和警察实施暴力经历与 HIV 风险行为和物质使用之间的关联。我们还评估了性别和社会经济地位在暴力暴露与 HIV 风险和多物质使用行为之间联系中的可能调节作用。数据来自普罗维登斯/波士顿-CFAR-乌克兰研究,该研究涉及乌克兰七个成瘾治疗机构的 191 名 HIV 阳性注射毒品者。逻辑回归的结果表明,经历过 IPV 的注射毒品者比没有经历过 IPV 的注射毒品者更有可能同时使用多种物质。警察实施的言语暴力和性暴力与不坚持使用安全套的几率增加有关。与警察身体虐待相比,女性从事多物质使用的几率较低。我们没有发现证据支持社会经济地位的调节作用。在乌克兰的这组 HIV 阳性注射毒品者中,暴力经历与物质使用和性 HIV 风险行为有关。考虑到个人和结构性暴力的基于创伤的预防方法可以降低该人群的 HIV 风险。
Glob Public Health. 2022-12
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