Correa-Salazar Catalina, Braverman-Bronstein Ariela, Bilal Usama, Groves Ali K, Page Kathleen R, Amon Joseph J, Vera Alejandra, Ballesteros Laura, Martínez-Donate Ana
Department of Community Health and Prevention, Drexel University, Philadelphia, Pennsylvania, United States of America.
Epidemiology and Biostatistics Department, Drexel University, Philadelphia, Pennsylvania, United States of America.
PLOS Glob Public Health. 2023 Feb 24;3(2):e0001571. doi: 10.1371/journal.pgph.0001571. eCollection 2023.
Gender, violence, and migration structurally impact health. The Venezuelan humanitarian crisis comprises the largest transnational migration in the history of the Americas. Colombia, a post-conflict country, is the primary recipient of Venezuelans. The Colombian context imposes high levels of violence on women across migration phases. There is little information on the relationship between violence and HIV risk in the region and how it impacts these groups. Evidence on how to approach the HIV response related to Venezuela's humanitarian crisis is lacking. Our study seeks to 1) understand how violence is associated with newly reported HIV/AIDS case rates for women in Colombian municipalities; and 2) describe how social violence impacts HIV risk, treatment, and prevention for Venezuelan migrant and refugee women undergoing transnational migration and resettlement in Colombia. We conducted a concurrent mixed-methods design. We used negative binomial models to explore associations between social violence proxied by Homicide Rates (HR) at the municipality level (n = 84). The also conducted 54 semi-structured interviews with Venezuelan migrant and refugee women and key informants in two Colombian cities to expand and describe contextual vulnerabilities to HIV risk, prevention and care related to violence. We found that newly reported HIV cases in women were 25% higher for every increase of 18 homicides per 100,000, after adjusting for covariates. Upon resettlement, participants cited armed actors' control, lack of government accountability, gender-based violence and stigmatization of HIV as sources of increased HIV risk for VMRW. These factors impose barriers to testing, treatment and care. Social violence in Colombian municipalities is associated with an increase in newly reported HIV/AIDS case rates in women. Violence hinders Venezuelan migrant and refugee women's access and engagement in available HIV prevention and treatment interventions.
性别、暴力和移民在结构上会影响健康。委内瑞拉人道主义危机构成了美洲历史上规模最大的跨国移民潮。哥伦比亚作为一个冲突后国家，是委内瑞拉移民的主要接收国。哥伦比亚的环境在移民的各个阶段都给妇女带来了高度的暴力。关于该地区暴力与艾滋病毒感染风险之间的关系以及其如何影响这些群体的信息很少。缺乏关于如何应对与委内瑞拉人道主义危机相关的艾滋病毒问题的证据。我们的研究旨在：1）了解暴力如何与哥伦比亚各市新报告的女性艾滋病毒/艾滋病病例率相关联；2）描述社会暴力如何影响在哥伦比亚进行跨国移民和重新安置的委内瑞拉移民及难民妇女的艾滋病毒感染风险、治疗和预防情况。我们采用了同步混合方法设计。我们使用负二项式模型来探索以各市凶杀率（HR）为代表的社会暴力之间的关联（n = 84）。我们还对哥伦比亚两个城市的委内瑞拉移民及难民妇女和关键信息提供者进行了54次半结构化访谈，以扩展并描述与暴力相关的艾滋病毒感染风险、预防和护理方面的背景脆弱性。我们发现，在调整协变量后，每10万人中凶杀案每增加18起，新报告的女性艾滋病毒病例就会增加25%。重新安置后，参与者指出武装行为体的控制、政府缺乏问责、基于性别的暴力以及对艾滋病毒的污名化是委内瑞拉移民及难民妇女艾滋病毒感染风险增加的原因。这些因素给检测、治疗和护理带来了障碍。哥伦比亚各市的社会暴力与新报告的女性艾滋病毒/艾滋病病例率上升有关。暴力阻碍了委内瑞拉移民及难民妇女获得并参与现有的艾滋病毒预防和治疗干预措施。
