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通过小额信贷与降低艾滋病毒风险干预措施相结合来减少对性交易妇女和吸毒妇女的伴侣暴力行为:一项整群随机试验

Reducing Partner Violence Against Women who Exchange Sex and use Drugs through a Combination Microfinance and HIV Risk Reduction Intervention: A Cluster Randomized Trial.

作者信息

Witte Susan S, Pala Andrea Norcini, Mukherjee Trena I, Yang Lyla S, McCrimmon Tara, Mergenova Gaukhar, Terlikbayeva Assel, Primbetova Sholpan, El-Bassel Nabila

机构信息

School of Social Work, Columbia University, New York, NY, USA.

Global Health Research Center of Central Asia, Columbia University School of Social Work, New York, NY, USA.

出版信息

AIDS Behav. 2023 Dec;27(12):4084-4093. doi: 10.1007/s10461-023-04122-z. Epub 2023 Jun 30.


DOI:10.1007/s10461-023-04122-z
PMID:37389675
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11041061/
Abstract

Women who exchange sex and use drugs (WESUD) are at high risk for HIV infection and partner violence. The few tested interventions at the intersection of HIV and IPV show mixed results. This analysis examined the impact of a combination HIV risk reduction (HIVRR) and microfinance (MF) intervention on reported paying and intimate partner violence against WESUD in Kazakhstan. This cluster randomized controlled trial enrolled 354 women from 2015 to 2018 and randomized them to either a combination of HIVRR and MF intervention or HIVRR alone. Outcomes were assessed at four time points over 15 months. Logistic regression within a Bayesian approach assessed change in odds ratio (OR) of recent physical, psychological, or sexual violence perpetrated by current or past intimate partners; and paying partners/clients by study arm over time. Compared to the control arm, the combination intervention decreased the odds of participants experiencing physical violence from past intimate partners by 14% (OR = 0.861, p = 0.049). Women in the intervention group reported significantly lower rates of sexual violence from paying partners (HIVRR + MF - HIVRR: 25.9%; OR = 0.741, p = 0.019) at 12-month follow-up. No significant differences in rates from current intimate partners were found. A combination HIVRR and microfinance intervention may reduce gender-based violence from paying and intimate partners among WESUD above and beyond HIVRR interventions alone. Future research should examine how microfinance reduces partner violence and how to implement combination interventions in diverse settings.

摘要

从事性交易和吸毒的女性(WESUD)面临着感染艾滋病毒和遭受伴侣暴力的高风险。在艾滋病毒与亲密伴侣暴力交叉领域进行的少数经过测试的干预措施显示出好坏参半的结果。本分析研究了降低艾滋病毒风险(HIVRR)与小额融资(MF)相结合的干预措施对哈萨克斯坦从事性交易和吸毒的女性报告的付费暴力和亲密伴侣暴力的影响。这项整群随机对照试验在2015年至2018年期间招募了354名女性,并将她们随机分为接受HIVRR与MF干预相结合的组或仅接受HIVRR干预的组。在15个月内的四个时间点评估结果。采用贝叶斯方法进行逻辑回归,评估研究组中当前或过去的亲密伴侣实施的近期身体、心理或性暴力;以及随着时间推移付费伴侣/客户的优势比(OR)变化。与对照组相比,联合干预使参与者遭受过去亲密伴侣身体暴力的几率降低了14%(OR = 0.861,p = 0.049)。在12个月的随访中,干预组的女性报告称来自付费伴侣的性暴力发生率显著较低(HIVRR + MF - HIVRR:25.9%;OR = 0.741,p = 0.019)。未发现来自当前亲密伴侣的发生率有显著差异。HIVRR与小额融资相结合的干预措施可能会减少从事性交易和吸毒的女性中来自付费和亲密伴侣的基于性别的暴力,其效果超过单独的HIVRR干预措施。未来研究应探讨小额融资如何减少伴侣暴力以及如何在不同环境中实施联合干预措施。

相似文献

[1]
Reducing Partner Violence Against Women who Exchange Sex and use Drugs through a Combination Microfinance and HIV Risk Reduction Intervention: A Cluster Randomized Trial.

AIDS Behav. 2023-12

[2]
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[3]
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[4]
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[5]
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[6]
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[7]
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[8]
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[9]
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[10]
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引用本文的文献

[1]
Effects of economic empowerment and relationship strengthening intervention on financial behaviors among couples living with HIV: The pilot trial in Malawi.

SSM Popul Health. 2025-2-25

[2]
The impact of an economic empowerment intervention on intimate partner violence among women engaged in sex work in southern Uganda: A cluster randomized control trial.

Soc Sci Med. 2024-5

本文引用的文献

[1]
Intertwined epidemics: progress, gaps, and opportunities to address intimate partner violence and HIV among key populations of women.

Lancet HIV. 2022-3

[2]
A Systematic Review of Gender-Based Violence Prevention and Response Interventions for HIV Key Populations: Female Sex Workers, Men Who Have Sex With Men, and People Who Inject Drugs.

Trauma Violence Abuse. 2022-4

[3]
A cluster-randomized controlled trial of a combination HIV risk reduction and microfinance intervention for female sex workers who use drugs in Kazakhstan.

J Int AIDS Soc. 2021-5

[4]
Microfinance and violence prevention: A review of the evidence and adaptations for implementation in the U.S.

Prev Med. 2020-2-10

[5]
Gender-based violence and engagement in biomedical HIV prevention, care and treatment: a scoping review.

BMC Public Health. 2019-7-8

[6]
What determines violence among female sex workers in an intimate partner relationship? Findings from North Karnataka, south India.

BMC Public Health. 2019-3-29

[7]
Still a leap of faith: microfinance initiatives for reduction of violence against women and children in low-income and middle-income countries.

BMJ Glob Health. 2018-12-1

[8]
The syndemic effect of injection drug use, intimate partner violence, and HIV on mental health among drug-involved women in Kazakhstan.

Glob Soc Welf. 2018-6

[9]
The global response and unmet actions for HIV and sex workers.

Lancet. 2018-7-20

[10]
Economic strengthening for HIV testing and linkage to care: a review of the evidence.

AIDS Care. 2018

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