Department of Medicine, University of Washington, Seattle, WA, USA.
Fenway Institute, Boston, MA, USA.
AIDS Behav. 2024 Sep;28(9):3170-3183. doi: 10.1007/s10461-024-04402-2. Epub 2024 Jul 16.
We examined past-year intimate partner violence (IPV), including psychological violence without physical/sexual violence, and health outcomes among people with HIV (PWH) in care in a multi-site U.S. cohort. Between 2016 and 2022, PWH reported 12-month psychological, physical, and sexual IPV in a routine assessment. We used linear and logistic regression models adjusted for age, race/ethnicity, and site to examine relationships with health outcomes. Among 9748 PWH (median age 50 years, 81% cisgender male/16% cisgender female/1% transgender female; 44% non-Hispanic white/36% non-Hispanic Black/15% Hispanic), 9.3% (n = 905) reported any IPV in the past 12 months; half reported psychological IPV without physical/sexual IPV (n = 453). PWH reporting any type of IPV were on average younger than those who did not experience IPV. In adjusted models, any IPV was associated with increased likelihood of unstable housing, HIV viral load detection (HIV viral load ≥ 75 copies/mL), moderate-to-severe depressive symptoms, anxiety with panic symptoms, substance use (methamphetamines, cocaine/crack, illicit opioids, marijuana, heavy episodic/hazardous drinking), and concern about exposure to sexually transmitted infection. PWH reporting any IPV in the past 12 months had 4.2% lower adherence to antiretroviral therapy, 2.4 more HIV-related symptoms, a 1.9 point higher HIV stigma score, and a 9.5% lower quality of life score than those without IPV. We found similar associations among PWH reporting only psychological IPV, without physical/sexual IPV. IPV was common among PWH. Half reporting IPV reported only psychological IPV and had similarly poor outcomes as those reporting physical/sexual IPV, demonstrating the need to assess psychological as well as physical and sexual IPV.
我们在美国的一个多地点队列中研究了过去一年中艾滋病毒感染者（PLHIV）中的亲密伴侣暴力（IPV），包括没有身体/性暴力的心理暴力，以及健康结果。在 2016 年至 2022 年期间，PLHIV 在常规评估中报告了 12 个月的心理、身体和性 IPV。我们使用线性和逻辑回归模型，根据年龄、种族/族裔和地点进行调整，以研究与健康结果的关系。在 9748 名 PLHIV（中位年龄 50 岁，81%为跨性别男性/16%为跨性别女性/1%为跨性别女性；44%为非西班牙裔白人/36%为非西班牙裔黑人/15%为西班牙裔）中，9.3%（n=905）报告在过去 12 个月中存在任何 IPV；一半报告了没有身体/性 IPV 的心理 IPV（n=453）。报告任何类型 IPV 的 PLHIV 平均比未经历 IPV 的 PLHIV 年轻。在调整后的模型中，任何类型的 IPV 都与不稳定住房、HIV 病毒载量检测（HIV 病毒载量≥75 拷贝/mL）、中重度抑郁症状、伴有惊恐症状的焦虑、物质使用（安非他命、可卡因/快克、非法阿片类药物、大麻、重度/危险饮酒）和对性传播感染的担忧的可能性增加有关。过去 12 个月报告任何 IPV 的 PLHIV 对抗逆转录病毒治疗的依从性降低了 4.2%，与 HIV 相关的症状增加了 2.4 个，HIV 耻辱感评分增加了 1.9 分，生活质量评分降低了 9.5%。我们在仅报告心理 IPV 而没有身体/性 IPV 的 PLHIV 中发现了类似的关联。PLHIV 中 IPV 很常见。报告 IPV 的一半人仅报告心理 IPV，其结果与报告身体/性 IPV 的人相似，这表明需要评估心理、身体和性 IPV。
