University of Central Florida, Orlando, FL, USA.
Florida International University, Miami, FL, USA.
J Interpers Violence. 2022 Aug;37(15-16):NP12998-NP13017. doi: 10.1177/08862605211001468. Epub 2021 Mar 22.
Knowledge and acceptability are key factors for pre-exposure prophylaxis (PrEP) use among women with a history of intimate partner violence (IPV) and research suggests that different types of IPV affect PrEP uptake differently. Few studies have examined whether the type (i.e., physical, sexual, and psychological) and timing (i.e., lifetime, past year) of IPV experiences are related to PrEP knowledge and acceptability, or whether gender roles and sexual risk behaviors affect PrEP use. We aimed to examine the associations between lifetime and past-year physical, sexual, and psychological IPV experiences on PrEP-related outcomes (i.e., knowledge, acceptability, sexual behavior if on PrEP) and the association between gender roles and PrEP-related outcomes. A total of 186 women of color at risk for HIV participated in this study, of whom 54% had ever experienced partner violence. Results showed that lifetime psychological (OR 3.0, 95% CI 1.1-9.4) and lifetime physical IPV (OR 5.5, 95% CI 1.2-18.9) were significantly associated with increased PrEP knowledge. lifetime psychological (OR 6.3, 95% CI 1.0-13.6) and lifetime physical IPV (OR 4.3, 95% CI 4.3-11.5) were significantly associated with increased sexual behavior if on PrEP. Past year physical IPV was significantly associated with interest in using PrEP (OR 1.9, 95% CI 1.7-4.3) and with sexual behavior if on PrEP (OR 4.0, 95% CI 1.1-13.1). Being subordinate to others was also significantly associated with interest in using PrEP (OR 1.5, 95% CI 1.2-2.4) Self-silencing was significantly associated with increased sexual behavior if on PrEP (OR 1.2, 95% CI 1.0-1.5). Gender norms and IPV type and timing can influence whether a person is interested in PrEP use. Both lifetime and past-year IPV experiences need to be examined in the context of gender norms when prescribing PrEP to encourage uptake and continuation among vulnerable women at risk for HIV.
知识和可接受性是有过亲密伴侣暴力（IPV）史的女性使用暴露前预防（PrEP）的关键因素，研究表明，不同类型的 IPV 对 PrEP 的接受程度不同。很少有研究调查过 IPV 经历的类型（即身体、性和心理）和时间（即终生、过去一年）是否与 PrEP 知识和可接受性相关，或者性别角色和性风险行为是否影响 PrEP 的使用。我们旨在研究终生和过去一年的身体、性和心理 IPV 经历与 PrEP 相关结果（即知识、可接受性、如果使用 PrEP 的性行为）之间的关联，以及性别角色与 PrEP 相关结果之间的关联。这项研究共有 186 名有色人种 HIV 高危女性参与，其中 54%的人曾经历过伴侣暴力。结果表明，终生心理（OR 3.0，95%CI 1.1-9.4）和终生身体 IPV（OR 5.5，95%CI 1.2-18.9）与 PrEP 知识的增加显著相关。终生心理（OR 6.3，95%CI 1.0-13.6）和终生身体 IPV（OR 4.3，95%CI 4.3-11.5）与如果使用 PrEP 的性行为增加显著相关。过去一年的身体 IPV 与使用 PrEP 的兴趣显著相关（OR 1.9，95%CI 1.7-4.3），与如果使用 PrEP 的性行为显著相关（OR 4.0，95%CI 1.1-13.1）。从属他人也与使用 PrEP 的兴趣显著相关（OR 1.5，95%CI 1.2-2.4），自我沉默与如果使用 PrEP 的性行为增加显著相关（OR 1.2，95%CI 1.0-1.5）。性别规范和 IPV 的类型和时间在为高危 HIV 女性开具 PrEP 时，可以影响她们对 PrEP 使用的兴趣。在为高危 HIV 女性开具 PrEP 时，需要在性别规范的背景下检查终生和过去一年的 IPV 经历，以鼓励脆弱的女性使用 PrEP 并继续使用。
