Montiel Ishino Francisco A, Rowan Claire, Ambikile Joel Seme, Conserve Donaldson F, Lopez Diana, Sabado-Liwag Melanie, Williams Faustine
Division of Intramural Research, National Institute on Minority Health and Health Disparities, National Institutes of Health, Bethesda, Maryland, United States of America.
Transdisciplinary Center for Health Equity Research, College of Education and Human Development, Texas A&M University, College Station, Texas, United States of America.
PLOS Glob Public Health. 2022 Aug 12;2(8):e0000831. doi: 10.1371/journal.pgph.0000831. eCollection 2022.
Intimate partner violence has adverse effects on mother's overall health and prevention of mother to child HIV transmission. To identify and examine subgroups of mothers experiencing intimate partner violence and the likelihood of HIV testing during antenatal care, we conducted a latent class analysis using data from the Tanzania Demographic and Health Survey 2010 (N = 2,809). Intimate partner violence included mother's experiences with partners' controlling behaviors, as well as emotional, physical, and sexual violence. The outcome was mother's accepting HIV testing offered during their antenatal care visit. Covariates included mother's level of education, rural/urban residence, and prevention of mother to child HIV transmission talk during antenatal care visit. The latent class analysis indicated a three-class solution was the best model and identified the following profiles: mothers with no experience of intimate partner violence (61% of sample) with a 90.5% likelihood of HIV testing; mothers with moderate levels of intimate partner violence (26%) with an 84.7% likelihood of testing; and mothers with extreme levels of intimate partner violence (13%) with an 82% likelihood of testing. An auxiliary multinomial logistic regression with selected covariates was conducted to further differentiate IPV profiles, where mothers with extreme levels of intimate partner violence had 57% increased odds [95%CI:1.06-2.33, p = .023] of living in rural areas compared to mothers with no experience of intimate partner violence. Our person-centered methodological approach provided a novel model to understand the impact of multiple intimate partner violence risk factors on antenatal care HIV testing to identify mothers in need of interventions and their children at highest for parent to child HIV transmission. Our model allows person-centered interventional designs tailored for the most at-risk subgroups within a population.
亲密伴侣暴力会对母亲的整体健康以及预防母婴传播艾滋病毒产生不利影响。为了识别和研究遭受亲密伴侣暴力的母亲亚组以及她们在产前护理期间接受艾滋病毒检测的可能性，我们利用2010年坦桑尼亚人口与健康调查的数据（N = 2809）进行了潜在类别分析。亲密伴侣暴力包括母亲在伴侣控制行为方面的经历，以及情感、身体和性暴力。结果变量是母亲在产前护理就诊时接受艾滋病毒检测的情况。协变量包括母亲的教育程度、城乡居住情况以及产前护理就诊期间关于预防母婴传播艾滋病毒的谈话。潜在类别分析表明，三类解决方案是最佳模型，并识别出以下几种情况：没有亲密伴侣暴力经历的母亲（占样本的61%）接受艾滋病毒检测的可能性为90.5%；亲密伴侣暴力程度中等的母亲（26%）接受检测的可能性为84.7%；亲密伴侣暴力程度极高的母亲（13%）接受检测的可能性为82%。我们进行了一项带有选定协变量的辅助多项逻辑回归分析，以进一步区分亲密伴侣暴力情况，结果显示，与没有亲密伴侣暴力经历的母亲相比，亲密伴侣暴力程度极高的母亲居住在农村地区的几率增加了57%[95%置信区间：1.06 - 2.33，p = 0.023]。我们以个体为中心的方法提供了一个新颖的模型，以了解多种亲密伴侣暴力风险因素对产前护理艾滋病毒检测的影响，从而识别出需要干预的母亲及其子女中母婴传播艾滋病毒风险最高的人群。我们的模型允许针对人群中风险最高的亚组进行以个体为中心的干预设计。
