Intimate partner violence, relationship power inequity, and incidence of HIV infection in young women in South Africa: a cohort study
Intimate partner violence, relationship power inequity, and incidence of HIV infection in young women in South Africa: a cohort study
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DOI：
10.1016/s0140-6736(10)60548-x
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发表时间：
2010-07-03
期刊：
影响因子：
168.9
通讯作者：
Shai, Nwabisa
中科院分区：
文献类型：
--
作者：
Jewkes, Rachel K.;Dunkle, Kristin;Shai, Nwabisa
背景横断面研究表明，亲密伴侣暴力和两性关系中的不平等与妇女艾滋病毒感染率的增加有关。然而，时间顺序和因果关系受到质疑，很少有艾滋病毒预防方案解决这些问题。我们评估是否亲密伴侣暴力和权力不平等的关系增加事件HIV infection in South African women.Methods的风险，我们做了纵向分析的数据，从以前发表的集群随机对照试验在南非的东开普省在2002-06年进行。1099名年龄在15-26岁之间的女性在基线时HIV阴性，并且在2年的随访中至少进行了一次额外的HIV检测。性别权力平等和亲密伴侣暴力行为分别通过性关系权力量表和世卫组织暴力侵害妇女行为工具进行衡量。发病率比（IRR）艾滋病毒收购在2年来自泊松模型，调整研究设计和单纯疱疹病毒2型感染，并用于计算人口归因fractions.Findings 128妇女获得艾滋病毒在2076人年的后续（发病率6.2每100人年）。在基线时具有低关系权力公平的325名妇女中有51名感染了艾滋病毒（8.5/100人-年），而具有中等或高关系权力公平的704名妇女中有73名感染了艾滋病毒（5.5/100人-年）;调整后的多变量泊松模型IRR 1-51，95% CI 1.05-2.17，p=0.027。在基线时报告有一次以上亲密伴侣暴力事件的253名妇女中有45人感染了艾滋病毒（每100人年9.6人），而在报告有一次或没有发生事件的846名妇女中有83人感染了艾滋病毒（每100人年5.2人）;调整后的多变量泊松模型IRR 1.51，1.04-2-21，p=0.032。人口归因分数分别为13.9%（95%CI 2.0-22-2）的关系权力的公平和11.9%（1.4-19.3）为intimate partner violence.Interpretation关系权力的不公平和亲密伴侣的暴力事件的风险增加艾滋病毒感染的年轻南非妇女。预防艾滋病毒的政策、干预措施和方案必须解决这两个风险因素，并分配适当的资源。
Background Cross-sectional studies have shown that intimate partner violence and gender inequity in relationships are associated with increased prevalence of HIV in women. Yet temporal sequence and causality have been questioned, and few HIV prevention programmes address these issues. We assessed whether intimate partner violence and relationship power inequity increase risk of incident HIV infection in South African women.Methods We did a longitudinal analysis of data from a previously published cluster-randomised controlled trial undertaken in the Eastern Cape province of South Africa in 2002-06. 1099 women aged 15-26 years who were HIV negative at baseline and had at least one additional HIV test over 2 years of follow-up were included in the analysis. Gender power equity and intimate partner violence were measured by a sexual relationship power scale and the WHO violence against women instrument, respectively. Incidence rate ratios (IRRs) of HIV acquisition at 2 years were derived from Poisson models, adjusted for study design and herpes simplex virus type 2 infection, and used to calculate population attributable fractions.Findings 128 women acquired HIV during 2076 person-years of follow-up (incidence 6.2 per 100 person-years). 51 of 325 women with low relationship power equity at baseline acquired HIV (8.5 per 100 person-years) compared with 73 of 704 women with medium or high relationship power equity (5.5 per 100 person-years); adjusted multivariable Poisson model IRR 1-51, 95% CI 1.05-2.17, p=0.027. 45 of 253 women who reported more than one episode of intimate partner violence at baseline acquired HIV (9.6 per 100 person-years) compared with 83 of 846 who reported one or no episodes (5.2 per 100 person-years); adjusted multivariable Poisson model IRR 1.51, 1.04-2-21, p=0.032. The population attributable fractions were 13.9% (95% CI 2.0-22-2) for relationship power equity and 11.9% (1.4-19.3) for intimate partner violence.Interpretation Relationship power inequity and intimate partner violence increase risk of incident HIV infection in young South African women. Policy, interventions, and programmes for HIV prevention must address both of these risk factors and allocate appropriate resources.