喀麦隆开始接受艾滋病毒护理的艾滋病毒感染者中的亲密伴侣暴力、抑郁、危险饮酒和社会支持。
Intimate partner violence, depression, hazardous alcohol use, and social support among people with HIV initiating HIV care in Cameroon.
机构信息
Department of Health Policy and Management, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States of America.
Clinical Research Education Networking and Consultancy, Yaoundé, Cameroon.
出版信息
PLoS One. 2024 May 21;19(5):e0304114. doi: 10.1371/journal.pone.0304114. eCollection 2024.
Intimate partner violence (IPV) has been associated with poor mental health among people with HIV (PWH) globally. Social support may be a strategy to foster mental health among PWH. Little is known about whether the relationship between IPV and mental health differs by IPV type or level of social support. Interviews were conducted with 426 PWH initiating HIV care in Cameroon. Log binomial regression analyses were used to estimate the association between four types of IPV (controlling behavior and emotional, physical, and sexual IPV) and symptoms of depression or hazardous alcohol use, separately by IPV type and level of social support. Over half (54.8%) of respondents experienced moderate/high levels of controlling behavior, 42.0% experienced emotional IPV, 28.2% experienced physical IPV and 23.7% experienced sexual IPV. Controlling behavior was associated with greater prevalence of depressive symptoms. This relationship did not vary meaningfully by level of social support (low: aPR 2.4 [95% CI 1.2, 4.9]; high: 1.7 [95% CI 1.0, 2.7]). Emotional and physical IPV were associated with greater prevalence of depressive symptoms among those with low social support (emotional IPV: aPR 1.9 [95% CI 1.0, 3.4]; physical IPV: aPR 1.8 [95% CI 1.2, 2.8]), but not among those with high social support (emotional IPV: aPR 1.0 [95% CI 0.7, 1.6]; physical IPV: aPR 1.0 [95% CI 0.6, 1.6]). Controlling behavior, emotional IPV, and physical IPV were associated with a greater prevalence of hazardous alcohol use, with moderately larger effect estimates among those with high compared to low social support. Sexual IPV was not associated with depressive symptoms or hazardous alcohol use. Services to screen and care for people experiencing IPV are urgently needed among PWH in Cameroon. Future research to identify barriers, feasibility, acceptability, and organizational readiness to integrate IPV and mental health services into HIV care settings is needed.
亲密伴侣暴力 (IPV) 与全球艾滋病毒感染者 (PWH) 的心理健康不良有关。社会支持可能是促进 PWH 心理健康的一种策略。关于 IPV 与心理健康之间的关系是否因 IPV 类型或社会支持水平而异，目前知之甚少。在喀麦隆，对 426 名开始接受艾滋病毒护理的 PWH 进行了访谈。使用对数二项式回归分析分别按 IPV 类型和社会支持水平估计四种类型的 IPV（控制行为和情感、身体和性 IPV）与抑郁症状或危险饮酒之间的关联。超过一半（54.8%）的受访者经历了中度/高度控制行为，42.0%经历了情感 IPV，28.2%经历了身体 IPV，23.7%经历了性 IPV。控制行为与抑郁症状的患病率较高有关。这种关系与社会支持水平的高低没有明显差异（低：aPR 2.4 [95%CI 1.2, 4.9]；高：1.7 [95%CI 1.0, 2.7]）。情感和身体 IPV 与低社会支持者中抑郁症状的患病率较高有关（情感 IPV：aPR 1.9 [95%CI 1.0, 3.4]；身体 IPV：aPR 1.8 [95%CI 1.2, 2.8]），但与高社会支持者无关（情感 IPV：aPR 1.0 [95%CI 0.7, 1.6]；身体 IPV：aPR 1.0 [95%CI 0.6, 1.6]）。控制行为、情感 IPV 和身体 IPV 与危险饮酒的患病率较高有关，而在高社会支持组中，这些关联的估计值适度较大。性 IPV 与抑郁症状或危险饮酒无关。喀麦隆的 PWH 迫切需要提供筛查和照顾 IPV 患者的服务。需要进一步研究确定将 IPV 和心理健康服务纳入艾滋病毒护理环境的障碍、可行性、可接受性和组织准备情况。
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