Witte Susan S, Pala Andrea Norcini, Mukherjee Trena I, Yang Lyla S, McCrimmon Tara, Mergenova Gaukhar, Terlikbayeva Assel, Primbetova Sholpan, El-Bassel Nabila
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.
AIDS Behav. 2023 Dec;27(12):4084-4093. doi: 10.1007/s10461-023-04122-z. Epub 2023 Jun 30.
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.
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。
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