INSERM, IRD, Aix Marseille Univ, SESSTIM, Sciences Economiques & Sociales de la Santé & Traitement de l'Information Médicale, Marseille, France.
Université Catholique d'Afrique Centrale, Yaoundé, Cameroun.
PLoS One. 2021 Feb 18;16(2):e0246192. doi: 10.1371/journal.pone.0246192. eCollection 2021.
Intimate partner violence (IPV) against women is frequent in Central Africa and may be a HIV infection risk factor. More data on HIV-positive men (MLHIV) committing IPV are needed to develop perpetrator-focused IPV and HIV prevention interventions. We investigated the relationship between IPV and HIV transmission risk and IPV-associated factors.
We used data from the cross-sectional survey EVOLCam which was conducted in Cameroonian outpatient HIV structures in 2014. The study population comprised MLHIV declaring at least one sexual partner in the previous year. Using principal component analysis, we built three variables measuring, respectively, self-reported MLHIV-perpetrated psychological and physical IPV (PPV), severe physical IPV (SPV), and sexual IPV (SV). Ordinal logistic regressions helped investigate: i) the relationship between HIV transmission risk (defined as unstable aviremia and inconsistent condom use) and IPV variables, ii) factors associated with each IPV variable.
PPV, SPV and SV were self-reported by 28, 15 and 11% of the 406 study participants, respectively. IPV perpetrators had a significantly higher risk of transmitting HIV than non-IPV perpetrators. Factors independently associated with IPV variables were: i) socio-demographic, economic and dyadic factors, including younger age (PPV and SPV), lower income (PPV), not being the household head (SPV and SV), living with a main partner (SPV), and having a younger main partner (SPV); ii) sexual behaviors, including ≥2 partners in the previous year (PPV and SPV), lifetime sex with another man (SPV), inconsistent condom use (SV), and >20 partners during lifetime (SV); iii) HIV-related stigma (PPV and SV).
IPV perpetrators had a higher risk of transmitting HIV and having lifetime and recent risky sexual behaviors. Perpetrating IPV was more frequent in those with socioeconomic vulnerability and self-perceived HIV-related stigma. These findings highlight the need for interventions to prevent IPV by MLHIV and related HIV transmission to their(s) partner(s).
在中非，亲密伴侣暴力（IPV）对女性来说很常见，并且可能是 HIV 感染的一个风险因素。需要更多关于感染 HIV 的男性（MLHIV）实施 IPV 的数据，以便制定以施害者为中心的 IPV 和 HIV 预防干预措施。我们调查了 IPV 与 HIV 传播风险以及与 IPV 相关的因素之间的关系。
我们使用了 2014 年在喀麦隆门诊艾滋病毒结构中进行的横断面调查 EVOLCam 的数据。研究人群包括在过去一年中至少有一名性伴侣的 MLHIV。我们使用主成分分析，分别构建了三个变量来衡量自我报告的 MLHIV 实施的心理和身体 IPV（PPV）、严重身体 IPV（SPV）和性 IPV（SV）。有序逻辑回归有助于调查：i）HIV 传播风险（定义为不稳定的病毒血症和不坚持使用避孕套）与 IPV 变量之间的关系，ii）与每个 IPV 变量相关的因素。
406 名研究参与者中，分别有 28%、15%和 11%自我报告了 PPV、SPV 和 SV。与非 IPV 施害者相比，IPV 施害者 HIV 传播的风险显著更高。与 IPV 变量独立相关的因素包括：i）社会人口经济学和伴侣关系因素，包括年龄较小（PPV 和 SPV）、收入较低（PPV）、不是家庭负责人（SPV 和 SV）、与主要伴侣同住（SPV）以及主要伴侣年龄较小（SPV）；ii）性行为，包括前一年有≥2 名性伴侣（PPV 和 SPV）、一生中与另一名男子发生性行为（SPV）、不坚持使用避孕套（SV）以及一生中超过 20 名性伴侣（SV）；iii）与 HIV 相关的耻辱感（PPV 和 SV）。
IPV 施害者 HIV 传播的风险更高，且具有终生和近期危险的性行为。在那些社会经济脆弱和自我感知的 HIV 相关耻辱感的人中，实施 IPV 的情况更为普遍。这些发现强调了需要干预措施，以防止 MLHIV 实施 IPV 并防止相关的 HIV 传播给他们的伴侣。
