Intimate partner violence among HIV positive women in care-results from a national survey, Uganda 2016
Intimate partner violence among HIV positive women in care-results from a national survey, Uganda 2016
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DOI：
10.1186/s12905-019-0831-1
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发表时间：
2019-11-01
影响因子：
2.5
通讯作者：
Wanyenze, Rhoda K.
中科院分区：
文献类型：
--
作者：
Kabwama, Steven Ndugwa;Bukenya, Justine;Wanyenze, Rhoda K.
背景由于包括亲密伴侣实施的暴力在内的社会文化因素，妇女仍然受到艾滋病毒/艾滋病流行病的不成比例的影响。在艾滋病毒阳性(HIV+)妇女中，亲密伴侣暴力(IPV)影响护理参与度和生殖健康结果。我们分析了一项全国性调查的数据，以估计在接受护理的HIV+妇女中IPV的流行率及其相关因素。方法对5198名接受护理的HIV阳性妇女进行调查。收集了关于社会人口学特征、自我报告的夫妇艾滋病毒状况、相互披露艾滋病毒状况和IPV的数据。对IPV的评估是通过询问参与者他们现在的丈夫或伴侣是否曾经打过、扇过、踢过或做过任何伤害他们身体的事情，以及他们现在的丈夫或伴侣是否曾经强迫他们发生性行为或进行任何违背他们意愿的性行为来进行评估。回答“是”的女性被归类为曾经经历过IPV。使用改进的泊松回归来确定与体验IPV相关的因素。结果在5198名HIV感染者中，1664人(32.1%)经历过身体暴力，1466人(28.3%)经历过性暴力，2290人(44.2%)经历过任何IPV。与女性和其男性伴侣年龄相同的女性相比，伴侣年轻1岁的女性更有可能经历IPV(患病率风险比=1.43，95%可信区间[95%CI]：1.10-1.71)，而伴侣年长10岁(PRR=1.20，95%CI：1.00-1.43)或>；=10岁(PRR=1.31，95%CI：1.05-1.64)的女性也是如此。与无亲生子女的妇女相比，有3~4个亲生子女的妇女更易患上IPV(PRR=1.27，95%CI：1.00~1.59)；有5个亲生子女的妇女发生IPV的可能性较大(PRR=1.34，95%CI：1.06~1.71)。与血清一致性关系中的女性相比，血清不一致性关系中的女性发生IPV的可能性较小(PRR=0.87，95%CI：0.78~0.98)。结论在乌干达，有很高比例的HIV+妇女曾经历过IPV。体验IPV与女性与其男性伴侣之间的亲密关系有关。卫生保健工作者应对接受IPV护理的艾滋病毒阳性妇女进行筛查，并提供适当的心理社会援助。
Background Women remain disproportionally affected by the HIV/ AIDS epidemic because of sociocultural factors including violence perpetrated by intimate partners. Among HIVpositive (HIV+) women, intimate partner violence (IPV) affects engagement in care and reproductive health outcomes. We analyzed data from a national survey to estimate the prevalence of IPV among HIV+ women in care and associated factors. Methods The study was conducted among 5198 HIV+ women in care. Data were collected on socio-demographic characteristics, self-reported couple HIV status, mutual HIV status disclosure and IPV. IPV was assessed by asking participants whether their current husband or partner ever hit, slapped, kicked or did anything to hurt them physically, and whether their current husband or partner ever physically forced them to have intercourse or perform any sexual acts against their will. Women who responded "yes" were classified as having ever experienced IPV. Modified Poisson regression was used to identify factors associated with experiencing IPV. Results Of 5198 HIV+ women, 1664 (32.1%) had ever experienced physical violence, 1466 (28.3%) had ever experienced sexual violence and 2290 (44.2%) had ever experienced any IPV. Compared with women in relationships where the woman and their male partner were of the same age, women in relationships where the partner was >= 1 year younger were more likely to ever experience IPV (Prevalence risk ratio [PRR] = 1.43, 95% Confidence Interval [95%CI]: 1.10-1.71), as were women in relationships where the partner was < 10 years older (PRR = 1.20, 95%CI: 1.00-1.43) or >= 10 years older (PRR = 1.31, 95%CI: 1.05-1.64). Compared with women who did not have biological children, women with 3-4 biological children were more likely to have ever experienced IPV (PRR = 1.27 95%CI: 1.00-1.59) as were those with >= 5 biological children (PRR = 1.34, 95%CI: 1.06-1.71). Compared with women in sero-concordant relationships, women in sero-discordant relationships were less likely to ever experience IPV (PRR = 0.87 95%CI: 0.78-0.98). Conclusions In Uganda, a high proportion of HIV+ women have ever experienced IPV. Experiencing IPV was associated with circumstances related to the intimate relationship between the woman and her male partner. Health care workers should screen HIV+ women in care for IPV and offer appropriate psychosocial assistance.