Latent Class Analysis of HIV Risk Behaviors Among Russian Women at Risk for Alcohol-Exposed Pregnancies.
Latent Class Analysis of HIV Risk Behaviors Among Russian Women at Risk for Alcohol-Exposed Pregnancies.
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DOI：
10.1007/s10461-017-1929-9
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发表时间：
2017-11
影响因子：
4.4
通讯作者：
Balachova T
中科院分区：
文献类型：
--
作者：
Bohora S;Chaffin M;Shaboltas A;Bonner B;Isurina G;Batluk J;Bard D;Tsvetkova L;Skitnevskaya L;Volkova E;Balachova T
在世界范围内，由异性性接触引起的艾滋病毒病例数量和艾滋病毒阳性个体中妇女的比例有所增加。俄罗斯是该地区新诊断的艾滋病毒感染率最高的国家，而且这种感染蔓延到传统的危险群体之外。虽然年轻妇女受到的影响不成比例，但一般人群中妇女对艾滋病毒危险行为的了解仍然有限。本研究的目的是确定育龄妇女处于艾滋病毒传播高风险的行为模式，并确定社会人口统计学特征和酒精使用是否可以预测这种风险模式。共有708名年龄在18-44岁之间、有酒精暴露妊娠风险（AEP）的未怀孕妇女参加了俄罗斯两个地区的研究。参与者完成了一项结构化访谈，重点是艾滋病毒风险行为，包括危险的性行为以及酗酒和吸毒。使用潜在类别分析来检查艾滋病毒风险与其他人口统计学和酒精使用特征之间的关系，并确定妇女的风险模式。确定了三个类别。34.93%的参与者是高危人群，结合他们的危险行为，如有多个性伴侣，以及与伴侣吸毒相关的高风险伴侣（I类）。尽管报告了自我感知的艾滋病毒/性传播感染风险，但这类参与者不太可能采取适当的保护措施（即使用安全套）。第二类高风险人群包括13.19%的参与者，他们既有危险的性行为，即有多个性伴侣和患有性病，又有伴侣的风险，包括伴侣被监禁和与其他女性发生性关系（第二类）。该课程的参与者可能会使用保护措施/避孕套。最后，51.88%的参与者处于较低的风险，这主要与他们的伴侣的风险有关，这些参与者使用了保护措施（III类）。在酒精使用障碍鉴定测试分数≥8的女性中，与得分较低的女性相比，属于I类的几率高出3.3倍（95% CI:[1.06, 10.38]），在性行为前饮酒的女性比不饮酒的女性高出3.9倍（95% CI:[1.69, 8.97]）。此外，每周饮酒天数较多的女性属于II类的可能性是III类的1.36倍。该研究通过确定特定人群和干预目标为预防提供信息。饮酒是妇女感染艾滋病毒风险的重要预测因素和首要因素。由于危险饮酒在俄罗斯年轻妇女中很常见，减少酒精风险应成为预防艾滋病毒工作的一个重要组成部分。
The number of HIV cases attributed to heterosexual contact and the proportion of women among HIV positive individuals has increased worldwide. Russia is a country with the highest rates of newly diagnosed HIV infections in the region, and the infection spreads beyond traditional risk groups. While young women are affected disproportionately, knowledge of HIV risk behaviors in women in the general population remains limited. The objectives of this study were to identify patterns of behaviors that place women of childbearing age at high risk for HIV transmission and determine whether socio-demographic characteristics and alcohol use are predictive of the risk pattern. A total of 708 non-pregnant women, aged between 18–44 years, who were at risk for an alcohol-exposed pregnancy (AEP) were enrolled in two regions in Russia. Participants completed a structured interview focused on HIV risk behaviors, including risky sexual behavior and alcohol and drug use. Latent class analysis was utilized to examine associations between HIV risk and other demographic and alcohol use characteristics and to identify patterns of risk among women. Three classes were identified. 34.93% of participants were at high risk, combining their risk behaviors, e.g., having multiple sexual partners, with high partner's risk associated with partner's drug use (class I). Despite reporting self-perceived risk for HIV/STI, this class of participants was unlikely to utilize adequate protection (i.e., condom use). The second high risk class included 13.19% of participants who combined their risky sexual behaviors, i.e., multiple sexual partners and having STDs, with partner's risk that included partner's imprisonment and partner's sex with other women (class II). Participants in this class were likely to utilize protection/condoms. Finally, 51.88% of participants were at lower risk, which was associated primarily with their partners' risk, and these participants utilized protection (class III). The odds of being in class I compared with class III were 3.3 (95% CI: [1.06, 10.38]) times higher for those women who had Alcohol Use Disorders Identification Test scores ≥8 than those who had lower scores, and were 3.9 (95% CI: [1.69, 8.97]) times higher for those who used alcohol before sex than those who did not. In addition, women who drank more days per week were 1.36 times more likely to be in class II than in class III. The study informs prevention by identifying specific population groups and targets for interventions. Alcohol use is a significant predictor and an overarching factor of HIV risk in women. Since at-risk drinking is common among young Russian women, alcohol risk reduction should be an essential component of HIV prevention efforts.
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