Diagnosis and Disclosure of HIV Status: Implications for Women's Risk of Physical Partner Violence in the Postpartum Period.
Diagnosis and Disclosure of HIV Status: Implications for Women's Risk of Physical Partner Violence in the Postpartum Period.
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DOI：
10.1097/qai.0000000000001012
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发表时间：
2016-08-15
期刊：
影响因子：
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通讯作者：
Moodley D
中科院分区：
文献类型：
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作者：
Maman S;Groves AK;McNaughton Reyes HL;Moodley D
这项研究前瞻性地研究了艾滋病毒是否会导致妇女遭受亲密伴侣暴力（IPV）的风险增加，以及这种风险如何根据向伴侣披露艾滋病毒状况而变化。我们使用来自1092名在南非德班参加RCT的孕妇和产后妇女的数据运行了一系列逻辑回归模型。第一个模型评估了基线HIV状态是否预测产后14周的身体IPV，控制基线身体IPV，向伴侣披露，人口统计学和研究协变量。模式2增加了艾滋病毒状况和披露之间的相互作用。HIV与14周物理IPV无关，主效应模型调整的比值比（AOR）为1.34，95% CI：0.88 - 2.05）。然而，艾滋病毒和披露之间存在统计学显著的积极相互作用（AOR 0.22，95% CI：0.05 - 0.96）。在披露其HIV状态的女性中，HIV与14周IPV无显著相关性（AOR 1.12; 95%CI 0.71-1.89）。然而，在未披露的女性中，与HIV阴性女性相比，HIV阳性女性在14周时报告IPV的几率高5.15倍（95% CI：1.25-21.00）。虽然我们确定艾滋病毒不会增加所有艾滋病毒阳性妇女的IPV发病率，但我们发现，选择不向伴侣透露其状况的艾滋病毒阳性妇女的IPV风险升高。不披露可能是关系中其他问题方面的标志，咨询师应该找到其他安全的披露选择，或者支持女性不披露的决定。
This study prospectively examined whether HIV leads to elevated risk for intimate partner violence (IPV) for women, and how this risk varies depending on HIV status disclosure to a partner. We ran a series of logistic regression models using data from 1092 pregnant and postpartum women enrolled in an RCT in Durban, South Africa, The first model assessed whether baseline HIV-status predicted 14-week postpartum physical IPV, controlling for baseline physical IPV, disclosure to partner, demographic and study covariates. Model 2 added the interaction between HIV status and disclosure. HIV was not associated with 14-week physical IPV in the main effects model adjusted odds ratio (AOR) 1.34, 95% CI: .88 - 2.05). However, there was a statistically significant positive interaction between HIV and disclosure, (AOR 0.22, 95% CI: .05-.96). Among women who disclosed their HIV status, HIV was not significantly associated with 14-week IPV (AOR 1.12; 95% CI 0.71-1.89). However, among women who had not disclosed, the odds of reporting IPV at 14 weeks was 5.15 times higher for HIV-positive women as compared to HIV-negative women (95% CI: 1.25-21.00). While we established that HIV does not increase incidence of IPV for all HIV-positive women, we found an elevated risk of IPV among the HIV-positive women who chose not to disclose their status to their partner. Non-disclosure is likely a marker for other problematic aspects of the relationship, and counselors should either find alternative safe options for disclosure or support women’s decisions not to disclose.