Impact of intimate partner violence on clinic attendance, viral suppression and CD4 cell count of women living with HIV in an urban clinic setting.
Impact of intimate partner violence on clinic attendance, viral suppression and CD4 cell count of women living with HIV in an urban clinic setting.
复制标题
DOI：
10.1080/09540121.2018.1428725
复制
发表时间：
2018-04
期刊：
影响因子：
1.7
通讯作者：
Farley J
中科院分区：
文献类型：
--
作者：
Anderson JC;Campbell JC;Glass NE;Decker MR;Perrin N;Farley J
药物滥用、暴力和艾滋病毒/艾滋病是影响妇女生活的一系列复杂的社会健康决定因素。具体而言，越来越多的证据表明，亲密伴侣暴力使妇女面临感染艾滋病毒和艾滋病毒相关后果恶化的风险。本研究评估了HIV诊所中IPV的患病率，以及IPV、抑郁症状和PTSD与三个HIV相关结局（CD 4计数、病毒载量和错过门诊）之间的关联。总共有239名成年妇女参加了艾滋病毒专科诊所。百分之五十一（95% CI：45-58%）报告过去一年的心理，身体或性亲密伴侣虐待。在未调整的模型中，IPV与CD 4计数<200（OR：3.284，95%CI：1.251-8.619，p=0.016）和可检测的病毒载量（OR：1.842，95%CI：1.006-3.371，p=0.048）相关。IPV与过去一年所有类型诊所访视（OR：1.535，95% CI：0.920-2.560，p=0.101）或HIV专科诊所访视（OR：1.251，95% CI：0.732-2.140）缺失>33%无关。在多变量回归中，控制物质使用、精神健康症状和人口统计学协变量，IPV仍然与CD 4计数<200相关（OR：3.536，95%CI：1.114-11.224，p=0.032），但与病毒抑制无关。IPV和较低的CD 4计数之间的关联，但不遵守标志物，如病毒抑制和错过访问，表明需要检查潜在的生理影响的创伤，可能会改变免疫功能的妇女感染艾滋病毒。将创伤知情的方法引入当前的艾滋病毒护理环境是开始解决该患者人群中IPV的一个机会。
The substance abuse, violence and HIV/AIDS (SAVA) syndemic represents a complex set of social determinants of health that impacts the lives of women. Specifically, there is growing evidence that intimate partner violence (IPV) places women at risk for both HIV acquisition and poorer HIV-related outcomes. This study assessed prevalence of IPV in an HIV clinic setting, as well as the associations between IPV, symptoms of depression and PTSD on three HIV-related outcomes—CD4 count, viral load, and missed clinic visits. In total, 239 adult women attending an HIV-specialty clinic were included. Fifty-one percent (95% CI: 45–58%) reported past year psychological, physical, or sexual intimate partner abuse. In unadjusted models, IPV was associated with having a CD4 count <200 (OR: 3.284, 95% CI: 1.251–8.619, p=0.016) and having a detectable viral load (OR: 1.842, 95% CI: 1.006–3.371, p=0.048). IPV was not associated with missing >33% of past year all type clinic visits (OR: 1.535, 95% CI: 0.920–2.560, p=0.101) or HIV specialty clinic visits (OR: 1.251, 95% CI: 0.732–2.140). In multivariable regression, controlling for substance use, mental health symptoms and demographic covariates, IPV remained associated with CD4 count <200 (OR: 3.536, 95% CI: 1.114–11.224, p=0.032), but not viral suppression. The association between IPV and lower CD4 counts, but not adherence markers such as viral suppression and missed visits, indicates a need to examine potential physiologic impacts of trauma that may alter the immune functioning of women living with HIV. Incorporating trauma-informed approaches into current HIV care settings is one opportunity that begins to address IPV in this patient population.
登录
查看更多内容
影响因子：
15.1
作者：
Out, Dorothee;Hall, Rosalie J.;Granger, Douglas A.;Page, Gayle G.;Woods, Stephanie J.
通讯作者：
Woods, Stephanie J.
影响因子：
3.3
作者：
Ruggiero, KJ;Del Ben, K;Rabalais, AE
通讯作者：
Rabalais, AE
影响因子：
3.5
作者：
Duterte, Erin E.;Bonomi, Amy E.;Rivara, Frederick P.
通讯作者：
Rivara, Frederick P.
影响因子：
0.5
作者：
Draughon, Jessica E.
通讯作者：
Draughon, Jessica E.
影响因子：
120.7
作者：
Feldhaus, KM;KoziolMcLain, J;Abott, JT
通讯作者：
Abott, JT