Intimate Partner Violence and the HIV Care and Treatment Cascade Among Adolescent Girls and Young Women in DREAMS, South Africa.
Intimate Partner Violence and the HIV Care and Treatment Cascade Among Adolescent Girls and Young Women in DREAMS, South Africa.
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DOI：
10.1097/qai.0000000000002843
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发表时间：
2022-02-01
期刊：
影响因子：
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通讯作者：
Hatcher A
中科院分区：
文献类型：
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作者：
Gibbs A;Reddy T;Closson K;Cawood C;Khanyile D;Hatcher A
补充数字内容在文本中可用。亲密伴侣暴力（IPV）可能会影响艾滋病毒治疗级联。南非的四个艾滋病毒高流行率DREAMS卫生区。对2017年3月至2018年6月收集的横断面数据进行二次分析，使用年轻（12-24岁）女孩和妇女的随机家庭样本。面对面访谈评估IPV和HIV状况知识，手指采血评估ART（抗逆转录病毒疗法）吸收和病毒抑制。我们使用逻辑回归来估计IPV对HIV知识、ART摄取和病毒抑制的粗效应和调整效应。在18 230名少女和年轻妇女中，有8 413人（46%）报告曾有过性行为，其中1 118人（13%）艾滋病毒呈阳性。90：90：90的基准是61%的人知道他们的状态，86%的人在他们的血液样本中存在ART，91%的人被病毒抑制。在感染艾滋病毒的年轻妇女的整个样本中，65.6%的病毒受到抑制。去年IPV报告为15%。在调整后的模型中，IPV倾向于增加年轻女性意识到自己感染HIV的几率[调整后的比值比（aOR）= 1.40，2.00-9.98，P = 0.067]。IPV和减少治疗使用之间没有关联（aOR = 0.73，0.41-1.29）。IPV与病毒抑制降低独立相关（aOR = 0.30，0.13-0.66）。解决IPV在破坏青少年和年轻妇女的治疗级联方面的作用是艾滋病毒方案拟订的一个关键问题。
Supplemental Digital Content is Available in the Text. Intimate partner violence (IPV) may affect the HIV-treatment cascade. Four high HIV-prevalence DREAMS health districts in South Africa. Secondary analysis of cross-sectional data collected March 2017–June 2018, using random household sample of young (12–24 years) girls and women. Face-to-face interviews assessed IPV and HIV-status knowledge, and finger-prick blood draws assessed ART (antiretroviral therapy) uptake and viral suppression. We used logistic regression to estimate crude and adjusted effects of IPV on HIV knowledge, ART uptake, and viral suppression. Of 18,230 adolescent girls and young women, 8413 (46%) reported ever having had sex, of whom 1118 (13%) were HIV positive. The 90:90:90 benchmarks were 61% knew their status, 86% had ART present in their blood sample, and 91% were virally suppressed. Among the entire sample of young women living with HIV, 65.6% were virally suppressed. Past year IPV was reported by 15%. In adjusted models, IPV trended toward increasing the odds that a young woman was aware she was living with HIV [adjusted odds ratios (aOR) = 1.40, 2.00–9.98, P = 0.067]. There was no association between IPV and reduced treatment use (aOR = 0.73, 0.41–1.29). IPV was independently associated with reduced viral suppression (aOR = 0.30, 0.13–0.66). Addressing the role of IPV in undermining the treatment cascade for adolescent and young women is a critical issue for HIV programming.