Targeting the SAVA (Substance Abuse, Violence, and AIDS) Syndemic Among Women and Girls: A Global Review of Epidemiology and Integrated Interventions.
Targeting the SAVA (Substance Abuse, Violence, and AIDS) Syndemic Among Women and Girls: A Global Review of Epidemiology and Integrated Interventions.
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DOI：
10.1097/qai.0000000000000626
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发表时间：
2015-06-01
期刊：
影响因子：
--
通讯作者：
Wyatt G
中科院分区：
文献类型：
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作者：
Gilbert L;Raj A;Hien D;Stockman J;Terlikbayeva A;Wyatt G
在使用或注射毒品的妇女和女孩中，有多种途径将基于性别的暴力与艾滋病毒和其他性传播感染联系起来。本文的目的是综合全球文献，审查药物滥用、暴力和艾滋病毒/艾滋病等协同流行之间的联系，即SAVA综合征。它还旨在确定针对SAVA主要综合征机制的多层次综合干预措施的连续体。我们使用PubMed、MEDLINE和谷歌Scholar进行了选择性搜索策略，优先使用荟萃分析流行病学和干预研究，这些研究涉及2000-2015年全球使用药物的妇女和女孩中SAVA综合征的不同方面。来自不同国家的有力证据表明，性别暴力大大增加了吸毒妇女和女孩感染艾滋病毒和其他性传播感染的风险。多种结构、生物和行为机制将妇女和女孩中的性别暴力和艾滋病毒联系起来。新出现的研究已经确定了一系列简短和扩展的多层次性别暴力预防和治疗干预措施，这些干预措施可以纳入艾滋病毒预防、检测和治疗干预措施的连续体中，以吸毒妇女和女孩中主要的性暴力感染综合征机制为目标。特别是在低收入和中等收入国家，在关于急性呼吸道感染综合征的流行病学和干预研究方面，仍然存在重大的方法和地理差距。这项全球审查强调有必要推进一系列多层次综合干预措施，针对吸毒的少女、年轻妇女和跨性别妇女的SAVA综合征的主要机制。
Multiple pathways link gender-based violence (GBV) to HIV and other sexually transmitted infections (STIs) among women and girls who use or inject drugs. The aim of this paper is to synthesize global literature that examines associations among the synergistic epidemics of substance abuse, violence and HIV/AIDS, known as the SAVA syndemic. It also aims to identify a continuum of multi-level integrated interventions that target key SAVA syndemic mechanisms. We conducted a selective search strategy, prioritizing use of meta-analytic epidemiological and intervention studies that address different aspects of the SAVA syndemic among women and girls who use drugs worldwide from 2000–2015 using PubMed, MEDLINE, and Google Scholar. Robust evidence from different countries suggests that GBV significantly increases the risk of HIV and other STIs among women and girls who use drugs. Multiple structural, biological and behavioral mechanisms link GBV and HIV among women and girls. Emerging research has identified a continuum of brief and extended multi-level GBV prevention and treatment interventions that may be integrated into a continuum of HIV prevention, testing, and treatment interventions to target key SAVA syndemic mechanisms among women and girls who use drugs. There remain significant methodological and geographical gaps in epidemiological and intervention research on the SAVA syndemic, particularly in low and middle-income countries. This global review underscores the need to advance a continuum of multi-level integrated interventions that target salient mechanisms of the SAVA syndemic, especially for adolescent girls, young women and transgender women who use drugs.