Transactional sex work and HIV among women in conflict-affected Northeastern Uganda: a population-based study.
Transactional sex work and HIV among women in conflict-affected Northeastern Uganda: a population-based study.
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DOI：
10.1186/s13031-022-00441-5
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发表时间：
2022-02-25
影响因子：
3.6
通讯作者：
Khoshnood K
中科院分区：
文献类型：
--
作者：
Mootz JJ;Odejimi OA;Bhattacharya A;Kann B;Ettelbrick J;Mello M;Wainberg ML;Khoshnood K
武装冲突和艾滋病毒大流行是重大的全球卫生问题。武装冲突与艾滋病毒感染之间存在关联的证据一直相互矛盾。我们的目标是研究中介风险因素的作用，例如参与交易性工作，以阐明武装冲突和艾滋病毒感染之间的关系。我们在乌干达东北部的三个地区采用多阶段抽样的方法，随机选择了605名年龄在13岁至49岁之间的女性，接受了2016年1月至5月的横断面调查。我们使用多元Logistic回归模型和R4.0.3来检验暴露在武装冲突中是否通过参与交易性工作间接影响了HIV阳性血清状态的报告。协变量包括年龄和地区居住地。暴露于武装冲突β = .16，SE = .04，p <； .05，或 = 1.17，95%[CI.08，.23]与报告艾滋病毒阳性血清状态显著相关。每增加1个单位的武装冲突暴露(即额外类型的武装冲突暴露)，报告艾滋病毒阳性血清状态的几率增加17%。从事交易性工作与报告艾滋病毒阳性血清状态β = .04，SE = .05，p = .37，95%无关[CI − .051，.138]。我们发现了居住地、年龄和交互作用的影响。尽管暴露在武装环境中与报告HIV阳性血清状态有关，但这种关系并不是通过参与交易性行为来调节的。需要对调节这种关系的风险因素进行进一步的研究。报告艾滋病毒阳性血清状态的可能性随着暴露于武装冲突的每一种额外类型而增加。因此，应在艾滋病毒预防环境中进行暴露于多种创伤性应激源的筛查。了解创伤情况并考虑精神痛苦的医疗服务可能会改善艾滋病毒的结果。
Armed conflict and the HIV pandemic are significant global health issues. Evidence of the association between armed conflict and HIV infection has been conflicting. Our objective was to examine the role of mediating risk factors, such as engagement in transactional sex work, to elucidate the relation between armed conflict and HIV infection. We used multistage sampling across three Northeastern Ugandan districts to randomly select 605 women aged 13 to 49 to answer cross-sectional surveys from January to May of 2016. We used multivariate logistic regression model with R 4.0.3 to examine if exposure to armed conflict has an indirect effect on reporting having an HIV-positive serostatus through engagement in transactional sex work. Age and district residence were included as covariates. Exposure to armed conflict β = .16, SE = .04, p < .05, OR = 1.17, 95% [CI .08, .23] was significantly associated with reporting a HIV-positive serostatus. For each 1-unit increase in exposure to armed conflict (i.e., additional type of armed conflict exposure), there was a 17% increase in the odds of reporting a HIV-positive serostatus. Engagement in transactional sex work was not associated with reporting a HIV-positive serostatus β = .04, SE = .05, p = .37, 95% [CI − .051, .138]. We found district of residence, age, and interaction effects. Although exposure to armed was associated with reporting an HIV-positive serostatus, this relationship was not mediated by engagement in transactional sex. Further research is needed on risk factors that mediate this relationship. The likelihood of reporting a HIV-positive serostatus increased with each additional type of exposure to armed conflict. Thus, screening for exposure to multiple traumatic stressors should occur in HIV prevention settings. Healthcare services that are trauma-informed and consider mental distress would likely improve HIV outcomes.
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影响因子：
1.3
作者：
Daw, Mohamed A.;El-Bouzedi, Abdallah;Dau, Aghnaya A.
通讯作者：
Dau, Aghnaya A.
影响因子：
3.2
作者：
Jabs, Lorelle
通讯作者：
Jabs, Lorelle
全面审查受冲突影响环境中性工作者的艾滋病毒/性传播感染预防以及性健康和生殖健康服务：呼吁在人道主义响应中采用基于证据和权利的方法。
影响因子：
3.6
作者：
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通讯作者：
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影响因子：
3.7
作者：
Bou-Karroum, Lama;El-Harakeh, Amena;Akl, Elie A.
通讯作者：
Akl, Elie A.
影响因子：
6.8
作者：
Cohen, Dara Kay
通讯作者：
Cohen, Dara Kay