作者：Caroline Cassels
出處：WebMD醫學新聞
August 14, 2008 — 新研究顯示，努力預防國內婦女的受虐事件，可以有助於全球對抗HIV感染。
印度一項大型族群基礎的已婚婦女研究顯示，相較於未受虐者，HIV感染流行率在那些遭遇身體和性暴力者中高出4倍。
波士頓哈佛公共衛生學院的Jay G. Silverman博士表示，他們的發現可以促進公共衛生政策制定者與開業醫師對於親密伴侶間的暴力(intimate-partner violence [IPV])的認知，且作為全球對抗HIV/AIDS的一個重要目標。
本研究登載於8月13日的美國醫療協會期刊(Journal of the American Medical Association)中有關暴力與人權的特別版中。
印度是世界上第三多HIV案例的國家，該國認為應增加HIV預防的資源；最近估計發現15至49歲之間的女性有0.22%、男性有0.36%為HIV陽性。
【婦女的HIV感染增加】
作者也指出，儘管印度一般族群的感染率降低，但婦女的HIV案例比率卻持續上升，丈夫的風險行為是婦女的主要感染源。他們也指出， IPV在印度和各地，與女性的異性間傳染HIV有關。
為了評估IPV和HIV感染率之間的關係，研究者分析了全國家庭健康調查中，2005年11月和2006年8月間28,139名已婚婦女的IPV 資料和HIV檢測結果。
總共有 35.4% 名參與者報告有暴力受虐事件，有或沒有來自丈夫性暴力；約有四分之一(27.8%)有受虐但無性暴力，7.6%有來自伴侶的身體和性方面的虐待；每450名婦女有1人(0.22%)為HIV陽性。
如果只有身體暴力，則與HIV感染風險無關，婦女的風險行為則在研究者的控制變項內，包括使用保險套和多重性伴侶等，和HIV感染風險無關。
根據作者表示，研究發現確認南亞和非洲所進行的研究結果，指出政策制定者需要在進行HIV預防策略時一併考量印度國內和全球的暴力事件，也建議需教育婦女有關IPV的觀念；不過，作者指出，更重要的是，改變男性一些不堪的高風險HIV行為。
他們寫道，目前，全球主要預防HIV的行動不足以體認這些問題的潛在嚴重性，這是HIV散佈的重要元素。
本研究接受兒童健康與人類發展國家研究中心支持。作者報告沒有相關宣告。
Fighting Domestic Violence May Help Stem Global HIV Epidemic
By Caroline Cassels
Medscape Medical News
August 14, 2008 — Efforts to prevent domestic abuse in women may aid in the global fight against HIV infection, new research suggests.
A large population-based study of married women in India shows the prevalence of HIV infection is 4 times greater among those who experience physical and sexual violence at the hands of their partners compared with women who are not abused.
Led by Jay G. Silverman, PhD, investigators at the Harvard School of Public Health, in Boston, Massachusetts, say their findings should "move public-health policy-makers and practitioners to increase recognition of intimate-partner violence [IPV] as a critically important target in the global fight against HIV/AIDS."
The study is published August 13 in the Journal of the American Medical Association, in a special theme issue on violence and human rights.
With the third-largest number of HIV cases of any country in the world, India is recognized as the source of increasing HIV prevalence. Recent estimates reveal 0.22% of women and 0.36% of men aged 15 to 49 years are HIV positive.
HIV Rising in Women
The authors also note that despite reductions in the prevalence of infection among India's general population, women account for a rising percentage of all HIV cases, with husbands' risk behavior described as a major source of women's infection. They also point out that IPV has been linked to heterosexual transmission of HIV to women in India and elsewhere.
To assess the relationship between IPV and the occurrence of HIV infection, the investigators analyzed data on 28,139 married women who provided IPV data and HIV test results during November 2005 and August 2006 as part of a national family health survey.
A total of 35.4% of subjects reported experiencing physical abuse, with or without sexual violence, from their husbands. About one-quarter (27.8%) reported physical abuse without sexual violence, and 7.6% reported both physical and sexual abuse by their partners. Approximately 1 in 450 women (0.22%) were HIV positive.
Physical violence alone was not associated with risk of HIV infection, and the women's risk behaviors that were within their control, including condom use and multiple partners, were not associated with HIV infection.
According to the authors, the study's findings confirm research conducted in South Asia and Africa and further highlight the need for policy makers to consider domestic violence when formulating HIV prevention strategies in India and across the globe.
Such initiatives should educate women about IPV. However, the authors note, more important are innovative efforts aimed at men to change abusive and high-risk HIV behaviors.
"Thus far, major global initiatives to prevent HIV have not sufficiently recognized the potential of such problems to alter this critical element in the spread of HIV," they write.
The study was supported by the National Institute of Child Health and Human Development. The authors report no relevant disclosures.
JAMA. 2008;300:703-710. Abstract
[ 本帖最後由 goodcat1111 於 2008-8-29 19:59 編輯 ] |
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