在乌干达，感染艾滋病毒的男性和女性中，不健康的饮酒行为和亲密伴侣暴力。
Unhealthy alcohol use and intimate partner violence among men and women living with HIV in Uganda.
机构信息
Division of Infectious Diseases, David Geffen School of Medicine, University of California, Los Angeles, CA, USA.
Division of HIV, Infectious Diseases, and Global Medicine, Department of Medicine, University of California San Francisco, San Francisco, CA, USA.
出版信息
BMC Public Health. 2022 Oct 10;22(1):1886. doi: 10.1186/s12889-022-14295-2.
BACKGROUND
Intimate partner violence (IPV) and alcohol use are interrelated public health issues. Heavy and frequent alcohol use increase the risk of IPV, but the relationship between alcohol use and IPV (including recent and lifetime IPV victimization and perpetration) has not been well described among persons living with HIV (PWH) in sub-Saharan Africa.
METHODS
We used baseline data from the Drinker's Intervention to Prevent Tuberculosis study. All participants were PWH co-infected with tuberculosis and had an Alcohol Use Disorders Identification Test - Consumption (AUDIT-C) positive score (hazardous drinking) and positive urine ethyl glucuronide test, indicating recent drinking. High-risk drinking was defined as AUDIT-C > 6 and/or alcohol biomarker phosphatidylethanol (PEth) ≥ 200 ng/mL. We measured IPV using the Conflict Tactics Scale. We estimated the association between alcohol use level and recent (prior six months) IPV victimization (recent perpetration was too low to study) using multivariable logistic regression models adjusted for gender, age, assets, education, spouse HIV status, religiosity, depressive symptoms, and social desirability. We additionally estimated the interaction of alcohol use and gender on IPV victimization and the association between alcohol use and lifetime victimization and perpetration.
RESULTS
One-third of the 408 participants were women. Recent IPV victimization was reported by 18.9% of women and 9.4% of men; perpetration was reported by 3.1% and 3.6% of women and men. One-fifth (21.6%) of those reporting recent IPV victimization also reported perpetration. In multivariable models, alcohol use level was not significantly associated with recent IPV victimization (p = 0.115), nor was the interaction between alcohol use and gender (p = 0.696). Women had 2.34 times greater odds of recent IPV victimization than men (p = 0.016). Increasing age was significantly associated with decreased odds of recent IPV victimization (p = 0.004).
CONCLUSION
Prevalence of IPV victimization was comparable to estimates from a recent national survey, while perpetration among men was lower than expected. Alcohol use level was not associated with IPV victimization. It is possible that alcohol use in this sample was too high to detect differences in IPV. Our results suggest that women and younger PWH are priority populations for IPV prevention.
背景
亲密伴侣暴力（IPV）和酒精使用是相互关联的公共卫生问题。大量和频繁的饮酒会增加 IPV 的风险，但在撒哈拉以南非洲地区的 HIV 感染者（PWH）中，酒精使用与 IPV（包括最近和终身 IPV 受害和施暴）之间的关系尚未得到很好的描述。
方法
我们使用了 Drinker's Intervention to Prevent Tuberculosis 研究的基线数据。所有参与者均为同时感染结核分枝杆菌和 HIV 的患者，他们的酒精使用障碍识别测试-消费（AUDIT-C）评分阳性（有危险的饮酒行为）且尿液乙基葡萄糖醛酸苷检测阳性，表明最近有饮酒行为。高风险饮酒定义为 AUDIT-C＞6 分和/或酒精生物标志物磷酰基乙醇（PEth）≥200ng/ml。我们使用冲突策略量表来衡量 IPV。我们使用多变量逻辑回归模型，根据性别、年龄、资产、教育、配偶 HIV 状况、宗教信仰、抑郁症状和社会期望调整，估计了酒精使用水平与最近（过去六个月）IPV 受害之间的关联（最近施暴的比例太低，无法进行研究）。我们还估计了酒精使用和性别对 IPV 受害的相互作用，以及酒精使用与终身受害和施暴的关系。
结果
408 名参与者中有 1/3 为女性。18.9%的女性和 9.4%的男性报告最近有 IPV 受害；3.1%的女性和 3.6%的男性报告最近有 IPV 施暴。1/5（21.6%）报告最近有 IPV 受害的人也报告了施暴。在多变量模型中，酒精使用水平与最近的 IPV 受害无关（p=0.115），酒精使用与性别之间的相互作用也无关（p=0.696）。与男性相比，女性最近发生 IPV 受害的可能性高 2.34 倍（p=0.016）。年龄增长与最近 IPV 受害的可能性降低显著相关（p=0.004）。
结论
IPV 受害的流行率与最近一项全国性调查的估计值相当，而男性施暴的比例则低于预期。酒精使用水平与 IPV 受害无关。在这个样本中，酒精使用量可能太高，以至于无法检测到 IPV 差异。我们的研究结果表明，女性和年轻的 PWH 是 IPV 预防的重点人群。
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