Prevalence and Correlates of HIV Disclosure Without Consent Among Women Living With HIV in Metro Vancouver, Canada.

IF 3.4 2区 医学 Q2 INFECTIOUS DISEASES AIDS patient care and STDs Pub Date : 2023-07-01 DOI:10.1089/apc.2023.0018
Mika S Ohtsuka, Kate Shannon, Andrea Krüsi, Melanie Lee, Desire King, Melissa Braschel, Kathleen Deering
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Abstract

This study identified the prevalence and perpetrators of HIV disclosure without consent, and social-structural correlates, among women living with HIV (WLWH). Data were drawn from 7 years (September 14 to August 21) of a longitudinal community-based open cohort of cis and trans WLWH living and/or accessing care in Metro Vancouver, Canada. The study sample included 1871 observations among 299 participants. Overall, 160 (53.3%) women reported lifetime HIV disclosure without consent at baseline, and 115 (38.5%) reported HIV disclosure without consent in the previous 6 months during 7 years of follow-up. In a subanalysis (n = 98), the most common perpetrators of HIV disclosure without consent were friends, people in the community, family, health professionals, and neighbors. In multivariable logistic regression analysis with generalized estimating equations, recent (last 6 months) housing insecurity [adjusted odds ratio (AOR): 1.43, 95% confidence interval: (1.10-1.86)], minoritized sexual identities (LGBQ2S) [AOR: 1.84 (1.22-2.78)], recently being treated, monitored, or diagnosed with depression, anxiety, or post-traumatic stress disorder [AOR: 1.37 (0.98-1.92)], and experiencing physical symptoms related to HIV [AOR: 1.75 (1.25-2.44)] was positively associated with recent disclosure without consent. In a context where HIV nondisclosure before sex is criminalized unless viral load is low and a condom is used, it is concerning that a large proportion of women have experienced HIV disclosure without consent. Laws should focus on protecting rights of WLWH, promoting equity, guaranteeing sexual and reproductive rights, and ensuring access to essential services and privacy. Findings highlight the need for trauma-informed approaches among health and housing services that are responsive to intersections of violence and stigma, and include a focus on confidentiality, autonomy, and safe disclosure practices.

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加拿大温哥华大都会HIV感染者中未经同意披露HIV的患病率和相关性。
这项研究确定了艾滋病毒感染者中未经同意披露艾滋病毒的流行率和实施者,以及社会结构相关性。数据来自加拿大温哥华大都会生活和/或获得护理的顺式和反式WLWH纵向社区开放队列的7年(9月14日至8月21日)。研究样本包括299名参与者中的1871个观察结果。总体而言,160名(53.3%)妇女在基线时报告了未经同意的终生艾滋病毒暴露,115名(38.5%)妇女在7年随访期间的前6个月内报告了未征得同意的艾滋病毒暴露。在子分析(n = 98),未经同意披露艾滋病毒的最常见肇事者是朋友、社区成员、家人、卫生专业人员和邻居。在具有广义估计方程的多变量逻辑回归分析中,最近(过去6个月)的住房不安全[调整比值比(AOR):1.43,95%置信区间:(1.10-1.86)],少数性别认同(LGBQ2S)[AOR:1.84(1.22-2.78)],最近接受治疗、监测或诊断为抑郁症、焦虑症或创伤后应激障碍[AOR:1.37(0.98-1.92)],并且经历与HIV相关的身体症状[AOR:1.75(1.25-2.44)]与最近未经同意的披露呈正相关。在除非病毒载量低并使用避孕套,否则性行为前不披露艾滋病毒被定为犯罪的情况下,令人担忧的是,很大一部分妇女在未经同意的情况下披露了艾滋病毒。法律应侧重于保护WLWH的权利,促进公平,保障性权利和生殖权利,并确保获得基本服务和隐私。调查结果强调,卫生和住房服务部门需要采取创伤知情的方法,应对暴力和污名的交叉点,并重点关注保密、自主和安全披露做法。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
AIDS patient care and STDs
AIDS patient care and STDs 医学-传染病学
CiteScore
7.00
自引率
22.40%
发文量
67
审稿时长
6-12 weeks
期刊介绍: AIDS Patient Care and STDs is the foremost journal providing the latest developments and research in diagnostics and therapeutics designed to prolong the lifespan and improve quality of life for HIV/AIDS patients. The Journal delivers cutting-edge clinical, basic science, sociologic, and behavior-based investigations in HIV/AIDS and other sexually transmitted infections. Clinical trials, quantitative and qualitative analyses of pilot studies, comprehensive reviews, and case reports are presented from leading experts and scientists around the world. AIDS Patient Care and STDs coverage includes: Prominent AIDS medications, therapies, and antiretroviral agents HIV/AIDS-related diseases, infections, and complications Challenges of medication adherence Current prevention techniques for HIV The latest news and developments on other STDs Treatment/prevention options, including pre- and post-exposure prophylaxis
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