Tucker Sydney, Winters Solis, Katabaro Emmanuel, Mlowe Matilda, Bradshaw Patrick, Ahern Jennifer, Colford John, Packel Laura, Hillis Susan, Sabasaba Amon, Njau Prosper, McCoy Sandra I
University of California, Berkeley, United States.
University of Oxford, Oxford, United Kingdom.
AIDS Res Ther. 2025 Jun 27;22(1):65. doi: 10.1186/s12981-025-00760-6.
Adverse childhood experiences (ACEs) can have lasting, detrimental effects throughout the lifespan and may influence engagement in health care. We conducted a case-cohort study in Tanzania to estimate the association between ACEs and disengagement from HIV care 12 months after initiating antiretroviral therapy (ART) among 217 adults (26 cases and 191 sub-cohort participants). Experiencing one, two, three, and four additional ACEs was significantly associated with 28% (RR= 1.24; 95% CI: 1.05, 1.44; p-value < 0.01), 64% (RR=1.64; 95% CI: 1.22, 2.20), 110% (RR=2.10; 95% CI: 1.35, 3.26), and 168% (RR=2.68; 95% CI: 1.49, 4.38) increases in the risk of disengagement from HIV care, respectively. These findings call for integrated trauma-informed mental health services within HIV care to end HIV/AIDS as a public health threat.
童年不良经历（ACEs）会在整个生命周期产生持久的有害影响，并可能影响医疗保健的参与度。我们在坦桑尼亚进行了一项病例队列研究，以评估217名成年人（26例病例和191名队列参与者）在开始抗逆转录病毒治疗（ART）12个月后，ACEs与脱离艾滋病毒护理之间的关联。经历另外1次、2次、3次和4次ACEs分别与脱离艾滋病毒护理风险增加28%（RR = 1.24；95% CI：1.05，1.44；p值<0.01）、64%（RR = 1.64；95% CI：1.22，2.20）、110%（RR = 2.10；95% CI：1.35，3.26）和168%（RR = 2.68；95% CI：1.49，4.38）显著相关。这些发现呼吁在艾滋病毒护理中提供综合的创伤知情心理健康服务，以消除艾滋病毒/艾滋病作为公共卫生威胁。
