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不良的童年经历与具有人类免疫缺陷病毒感染风险行为的成年人中的人类免疫缺陷病毒检测。

Adverse childhood experiences and human immunodeficiency virus testing among adults with human immunodeficiency virus risk behaviours.

机构信息

Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun, Jilin, China.

Chaoyang Center for Disease Control and Prevention, Beijing, China.

出版信息

Stress Health. 2024 Feb;40(1):e3262. doi: 10.1002/smi.3262. Epub 2023 May 24.

DOI:10.1002/smi.3262
PMID:37226429
Abstract

Adverse childhood experiences (ACEs) have been associated with poor HIV testing in adulthood yet, they have not been extensively described in those at increased risk for HIV. Cross-sectional analysis data (n = 204,231) on ACEs and HIV testing were obtained from the 2019-2020 Behavioural Risk Factor Surveillance Survey. Weighted logistic regression models were used to access the association of ACEs exposure, ACEs score, and ACEs type with HIV testing among adults with HIV risk behaviours, and stratified analysis was also performed to examine gender differences. The results indicated the overall rate of HIV testing was 38.8% and was higher among those with HIV risk behaviours (64.6%) than those without (37.2%). In populations with HIV risk behaviours, the negative association of HIV testing with ACEs exposure, ACEs score, and ACEs type was identified. Relative to those without ACEs, adults who were exposed to ACEs might decrease the rate of HIV testing, participants with ≥4 ACEs scores were less likely to have HIV testing, and childhood exposure to sexual abuse had the greatest impact on HIV testing. For both males and females, childhood exposure to ACEs was associated with lower odds of HIV testing and ACEs score ≥4 had the most robust associations with HIV testing. For males, those who experienced witnessed domestic violence had the lowest odds of HIV testing but the odds of engaging in HIV testing for females were the lowest among those who experienced childhood sexual abuse.

摘要

不良的童年经历(ACEs)与成年人中较差的 HIV 检测率相关,但在那些感染 HIV 风险较高的人群中,这些经历并没有得到广泛描述。我们从 2019-2020 年行为风险因素监测调查中获得了关于 ACEs 和 HIV 检测的横断面分析数据(n=204231)。使用加权逻辑回归模型来评估 ACEs 暴露、ACEs 评分和 ACEs 类型与具有 HIV 风险行为的成年人中 HIV 检测的关联,并进行了分层分析以检查性别差异。结果表明,总体 HIV 检测率为 38.8%,在具有 HIV 风险行为的人群中(64.6%)高于无风险行为的人群(37.2%)。在具有 HIV 风险行为的人群中,发现 HIV 检测与 ACEs 暴露、ACEs 评分和 ACEs 类型呈负相关。与没有 ACEs 的成年人相比,暴露于 ACEs 的成年人可能会降低 HIV 检测的比例,ACEs 评分≥4 的参与者进行 HIV 检测的可能性较小,而童年时期遭受性虐待对 HIV 检测的影响最大。对于男性和女性,童年时期遭受 ACEs 与 HIV 检测的可能性降低相关,ACEs 评分≥4 与 HIV 检测的关联最强。对于男性,目睹家庭暴力的人进行 HIV 检测的可能性最低,但遭受童年性虐待的女性进行 HIV 检测的可能性最低。

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