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亲密伴侣暴力对 HIV 阳性孕妇和产后妇女的不良影响:来自观察性研究的荟萃分析结果。

Adverse Impact of Intimate Partner Violence Against HIV-Positive Women During Pregnancy and Post-Partum: Results From a Meta-Analysis of Observational Studies.

机构信息

Department of Maternal, Child and Adolescent Health, School of Public Health, Fudan University, Shanghai, China.

Fujian Centre for Disease Control and Prevention, Fuzhou, China.

出版信息

Trauma Violence Abuse. 2023 Jul;24(3):1624-1639. doi: 10.1177/15248380211073845. Epub 2022 Mar 8.

Abstract

: Intimate partner violence (IPV) against pregnant or human immunodeficiency virus (HIV)-positive women have been previously studied. However, data on the impact of IPV on HIV-positive pregnant women have not been systematically synthesized. We performed a meta-analysis to explore this issue and provide evidence regarding IPV prevention and HIV infection control. : The PubMed, Web of Science, Cochrane Library, and Embase databases were systematically searched. Studies that quantitatively assessed the association between IPV and its adverse impact on HIV-positive women during pregnancy and post-partum were eligible for inclusion. Pooled odds ratios (ORs) were calculated. Eight studies were identified to meet our eligibility criteria. The adverse impacts of IPV against HIV-positive pregnant women mainly included nonadherence to maternal antiretroviral treatment during pregnancy, nondisclosure of HIV-positive status to male partners, nonadherence to infant antiretroviral prophylaxis, and antenatal depression. IPV caused a 180% and 145% increase in the odds of antenatal depression and nonadherence to infant antiretroviral prophylaxis, respectively, among HIV-positive women, compared to the odds of their IPV-free counterparts [OR = 2.80, 95% confidence interval (CI): 1.66-4.74; OR = 2.45, 95% CI: 1.40-4.27]. : Limited evidence has suggested that IPV against HIV-positive pregnant women caused maternal depression during pregnancy and led to the possible failure of HIV prophylaxis adherence in infants. Interventions to address IPV may ultimately reduce the risk of depression-related adverse birth outcomes and vertical transmission in infants exposed to maternal HIV. Prevention and control against IPV should be developed for HIV-positive pregnant women.

摘要

:针对怀孕或人类免疫缺陷病毒(HIV)阳性妇女的亲密伴侣暴力(IPV)先前已有研究。然而,关于 IPV 对 HIV 阳性孕妇影响的数据尚未得到系统综合。我们进行了一项荟萃分析,以探讨这一问题,并为 IPV 预防和 HIV 感染控制提供证据。:我们系统地检索了 PubMed、Web of Science、Cochrane Library 和 Embase 数据库。符合纳入标准的研究定量评估了 IPV 及其对怀孕期间和产后 HIV 阳性妇女的不良影响之间的关联。计算了合并优势比(OR)。:有八项研究符合我们的纳入标准。针对 HIV 阳性孕妇的 IPV 的不良影响主要包括在怀孕期间不遵守母亲抗逆转录病毒治疗、不向男性伴侣透露 HIV 阳性状况、不遵守婴儿抗逆转录病毒预防措施、产前抑郁。与无 IPV 的 HIV 阳性妇女相比,IPV 使 HIV 阳性孕妇发生产前抑郁和不遵守婴儿抗逆转录病毒预防措施的几率分别增加了 180%和 145%[OR=2.80,95%置信区间(CI):1.66-4.74;OR=2.45,95%CI:1.40-4.27]。:有限的证据表明,针对 HIV 阳性孕妇的 IPV 导致孕妇在怀孕期间抑郁,并可能导致婴儿无法遵守 HIV 预防措施。解决 IPV 的干预措施最终可能会降低与抑郁相关的不良母婴结局和婴儿暴露于母体 HIV 垂直传播的风险。应针对 HIV 阳性孕妇制定预防和控制 IPV 的措施。

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