Exploring the associations between physical and sexual gender-based violence and HIV among women who use substances in South Africa: the role of agency and alcohol
Exploring the associations between physical and sexual gender-based violence and HIV among women who use substances in South Africa: the role of agency and alcohol
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DOI：
10.1080/09540121.2019.1595512
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发表时间：
2019-03-27
影响因子：
1.7
通讯作者：
Wechsberg, Wendee M.
中科院分区：
文献类型：
--
作者：
Bonner, Courtney Peasant;Browne, Felicia A.;Wechsberg, Wendee M.
目标：南非是世界上妇女艾滋病毒感染率最高、基于性别的暴力 (GBV) 发生率最高、人均酒精消费率最高的国家。必须探索 GBV、酒精滥用和艾滋病毒之间的微妙关联，并确定保护因素。本研究探讨了身体和性方面的 GBV 与 HIV 感染之间的关联，并探讨了酒精滥用和性行为如何介导 GBV-HIV 关联。方法：参与者为 361 名非洲黑人女性（平均年龄 = 28.39，SD = 7.92），她们报告在过去 3 个月内每周饮酒和/或吸毒、进行无套性行为以及有男朋友。妇女是从南非比勒陀利亚的弱势社区招募的。符合资格标准并参加研究的个人同意并完成计算机辅助个人访谈，评估 GBV、酒精滥用和性行为，并接受 HIV 检测（即血液检测）。结果：由于酗酒而造成的身体攻击对入组时的 HIV 状况产生了显着的间接影响（对数赔率 = 0.23，SE = 0.12，95% CI [0.0151，0.4998]）。结论：以减少酒精滥用为重点的艾滋病毒预防工作可能更有效，这可能会减轻南非弱势妇女群体的艾滋病毒负担。
Objective: South Africa has the highest prevalence of HIV among women, the highest prevalence of gender-based violence (GBV), and the highest rates of per capita alcohol consumption in the world. The nuanced associations between GBV, alcohol misuse, and HIV must be explored and protective factors identified. This study examines the associations between physical and sexual GBV and HIV infection and explores how alcohol misuse and sexual agency may mediate the GBV-HIV association. Method: Participants were 361 Black African women (Mean age = 28.39, SD = 7.92) who reported using alcohol and/or drugs weekly in the past 3 months, engaging in condomless sex, and having a boyfriend. Women were recruited from disadvantaged communities in Pretoria, South Africa. Individuals who met the eligibility criteria and enrolled in the study consented and completed a computer-assisted personal interview assessing GBV, alcohol misuse, and sexual agency and underwent HIV testing (i.e., blood test). Results: The indirect effect of physical assault on HIV status at enrollment through alcohol misuse was significant (log odds = 0.23, SE = 0.12, 95% CI [0.0151, 0.4998]). Conclusions: HIV prevention efforts focusing on reducing alcohol misuse may be more effective, which might reduce the HIV burden among this group of vulnerable South African women.