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老年 HIV 感染者中的儿童期性创伤和阿片类药物使用。

Childhood sexual trauma and opioid use among older adults living with HIV.

机构信息

Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC, United States.

South Carolina SmartState Center for Healthcare Quality, Arnold School of Public Health, University of South Carolina, Columbia, SC, United States.

出版信息

AIDS Care. 2024 Dec;36(12):1852-1857. doi: 10.1080/09540121.2024.2390066. Epub 2024 Aug 12.

Abstract

Childhood sexual abuse (CSA) has been linked to substance use and substance use disorders in adulthood. However, there have been limited studies examining the relationship between CSA and opioid use among older adults living with HIV (OALH). Therefore, the aim of this study was to determine the association between CSA and opioid use among OALH ( = 91). Data were obtained from an HIV clinic population in South Carolina using paper-and-pen, and online questionnaires. CSA was operationalized using six questions from the Early Trauma Inventory-Self Report Form (Yes vs. No). Opioid use was self-report of the use of opioids including: heroin, fentanyl, Oxycontin, Vicodin, codeine, morphine (used vs. never used). Nested crude and multivariable logistic regression models adjusting for sociodemographic confounders were used to determine the association between CSA and opioid use. After adjusting for race, gender, age, and education, OALH who were CSA survivors were 21 times more likely to currently use opioids compared to OALH who were not exposed to CSA (adjusted OR: 21.1; 95% CI: 1.78-250.0). The association seen between CSA history and opioid use may be due to unresolved trauma among OALH. Trauma-informed interventions addressing CSA may help to reduce opioid use among OALH.

摘要

儿童期性虐待 (CSA) 与成年人的物质使用和物质使用障碍有关。然而,关于生活在 HIV 中的老年成年人 (OALH) 中 CSA 与阿片类药物使用之间关系的研究有限。因此,本研究旨在确定 OALH 中 CSA 与阿片类药物使用之间的关联(n=91)。数据来自南卡罗来纳州的一家 HIV 诊所人群,使用纸笔和在线问卷收集。CSA 通过早期创伤清单-自我报告表 (Yes 与 No) 的六个问题进行操作化。阿片类药物使用是自我报告的阿片类药物使用,包括:海洛因、芬太尼、奥施康定、维柯丁、可待因、吗啡(使用与从未使用)。使用嵌套的粗和多变量逻辑回归模型,调整社会人口统计学混杂因素,以确定 CSA 与阿片类药物使用之间的关联。在调整了种族、性别、年龄和教育程度后,CSA 幸存者 OALH 目前使用阿片类药物的可能性是未接触 CSA 的 OALH 的 21 倍(调整后的 OR:21.1;95%CI:1.78-250.0)。在 CSA 病史和阿片类药物使用之间观察到的关联可能是由于 OALH 中未解决的创伤。针对 CSA 的创伤知情干预措施可能有助于减少 OALH 中的阿片类药物使用。

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