Maya Sigal, Sheira Lila A, Frongillo Edward A, Pala Andrea Norcini, Kempf Mirjam-Colette, Konkle-Parker Deborah, Wilson Tracey E, Tien Phyllis C, Wingood Gina, Topper Elizabeth F, Neilands Torsten B, Johnson Mallory O, Logie Carmen H, Weiser Sheri D, Turan Janet M, Turan Bulent
School of Medicine, University of California, San Francisco, CA.
Arnold School of Public Health, University of South Carolina, Chapel Hill, NC.
J Acquir Immune Defic Syndr. 2025 Feb 1;98(2):99-102. doi: 10.1097/QAI.0000000000003538.
Interpersonal violence (IPV) affects half of women living with HIV (WLHIV) in the United States and has important consequences for mental health and HIV outcomes. Although different types of stigmas (eg, HIV- or sexual identity-related) are associated with increased risk of IPV, the relationship between poverty-related stigma and IPV is unclear, even though poverty frequently co-occurs with IPV.
Data from up to 4 annual visits (2016-2020) were collected from 374 WLHIV enrolled in a substudy of the Women's Interagency HIV Study (now known as Multicenter AIDS Cohort Study/Women's Interagency HIV Study Combined Cohort Study) at 4 sites across the United States. A validated measure of the perceived stigma of poverty was used, along with questions on recent experiences of IPV. We used a mixed-effects model to assess the association between internalized poverty stigma and IPV.
The unadjusted model with internalized poverty stigma and recent IPV as independent and dependent variables, respectively, suggested that the 2 were associated (prevalence ratio 1.29 [95% CI: 1.02 to 1.62, P = 0.033]). After adjusting for income and education, we found an independent association between internalized poverty-related stigma and recent IPV, with a prevalence ratio of 1.35 (95% CI: 1.07 to 1.71, P = 0.011).
Our findings suggest that reducing the psychologic consequences of poverty may better situate WLHIV to escape or avoid IPV. The usefulness of screening WLHIV who may be experiencing poverty-related stigma for IPV should be investigated. Interventions that address internalized poverty-related stigma may provide an avenue for reducing the harms caused by IPV in addition to interventions aiming to reduce violence itself.
人际暴力（IPV）影响着美国一半感染艾滋病毒的女性（WLHIV），并对心理健康和艾滋病毒感染状况产生重要影响。尽管不同类型的污名（如与艾滋病毒或性身份相关的污名）与IPV风险增加有关，但与贫困相关的污名和IPV之间的关系尚不清楚，尽管贫困经常与IPV同时出现。
从参与美国4个地点的女性机构间艾滋病毒研究（现称为多中心艾滋病队列研究/女性机构间艾滋病毒研究联合队列研究）子研究的374名WLHIV中收集了多达4次年度访视（2016 - 2020年）的数据。使用了一种经过验证的贫困感知污名测量方法，以及关于近期IPV经历的问题。我们使用混合效应模型来评估内化的贫困污名与IPV之间的关联。
以内化的贫困污名和近期IPV分别作为自变量和因变量的未调整模型表明，二者存在关联（患病率比1.29 [95%置信区间：1.02至1.62，P = 0.033]）。在对收入和教育进行调整后，我们发现内化的与贫困相关的污名和近期IPV之间存在独立关联，患病率比为1.35（95%置信区间：1.07至1.71，P = 0.011）。
我们的研究结果表明，减轻贫困的心理影响可能会使感染艾滋病毒的女性更好地摆脱或避免IPV。应研究对可能经历与贫困相关污名的感染艾滋病毒的女性进行IPV筛查的效用。除了旨在减少暴力本身的干预措施外，解决内化的与贫困相关的污名的干预措施可能为减少IPV造成的伤害提供一条途径。
