The intersections of HIV and violence: directions for future research and interventions
The intersections of HIV and violence: directions for future research and interventions
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DOI：
10.1016/s0277-9536(99)00270-1
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发表时间：
2000-02-01
影响因子：
5.4
通讯作者：
Gielen, AC
中科院分区：
文献类型：
--
作者：
Maman, S;Campbell, J;Gielen, AC
本文的目的是审查现有的文献艾滋病毒和暴力之间的交叉点，并提出了一个议程，为未来的研究，以指导政策和方案。本文旨在回答四个问题：（1）强迫性行为如何影响妇女感染艾滋病毒的风险？(2)暴力和暴力威胁如何影响妇女协商使用避孕套的能力？(3)感染艾滋病毒的妇女遭受暴力的风险是否比未感染的妇女更大？(4)现有证据对未来研究和干预方向的影响是什么？来自美国和撒哈拉以南非洲的29项研究为艾滋病毒流行与暴力之间的几种不同联系提供了证据。然而，有一些方法上的限制，可以克服与未来的研究。首先，需要进行更多的前瞻性研究，以说明暴力受害可能增加妇女感染艾滋病毒的风险的方式，以及艾滋病毒抗体阳性如何影响暴力风险。今后的研究需要描述男子对艾滋病毒风险和暴力的看法，以便制定针对男子和妇女的有效干预措施。今后需要统一身体暴力、强迫性行为、艾滋病毒风险和血清状况披露等概念的定义和衡量工具。最后，将定性和定量研究方法相结合将有助于描述问题的背景和范围。这些研究的服务意义是重大的。艾滋病毒咨询和检测方案提供了一个独特的机会，可以识别和帮助有遭受暴力风险的妇女，并识别因遭受攻击的历史而可能面临艾滋病毒高风险的妇女。此外，在存在预防暴力方案的环境中，这些方案也为妇女提供了关于其感染性传播疾病和艾滋病毒风险的咨询机会。(C)2000爱思唯尔科技有限公司版权所有。
The purpose of this paper is to review the available literature on the intersections between HIV and violence and present an agenda for future research to guide policy and programs. This paper aims to answer four questions: (1) How does forced sex affect women's risk for HIV infection? (2) How do violence and threats of violence affect women's ability to negotiate condom use? (3) Is the risk of violence greater for women living with HIV infection than for noninfected women? (4) What are the implications of the existing evidence for the direction of future research and interventions? Together this collection of 29 studies from the US and from sub-Saharan Africa provides evidence for several different links between the epidemics of HIV and violence. However, there are a number of methodological limitations that can be overcome with future studies. First, additional prospective studies are needed to describe the ways which violence victimization may increase women's risk for HIV and how being HIV positive affects violence risk. Future studies need to describe men's perspective on both HIV risk and violence in order to develop effective interventions targeting men and women. The definitions and tools for measurement of concepts such as physical violence, forced sex, HIV risk, and serostatus disclosure need to be harmonized in the future. Finally, combining qualitative and quantitative research methods will help to describe the context and scope of the problem. The service implications of these studies are significant. HIV counseling and testing programs offer a unique opportunity to identify and assist women at risk for violence and to identify women who may be at high risk for HIV as a result of their history of assault. In addition, violence prevention programs, in settings where such programs exist, also offer opportunities to counsel women about their risks for sexually transmitted diseases and HIV. (C) 2000 Elsevier Science Ltd. All rights reserved.