TY - JOUR
T1 - A prospective study of exposure to gender-based violence and risk of sexually transmitted infection acquisition in the women's interagency hiv study, 1995-2018
AU - Geller, Ruth J.
AU - Decker, Michele R.
AU - Adedimeji, Adebola A.
AU - Weber, Kathleen M.
AU - Kassaye, Seble
AU - Taylor, Tonya N.
AU - Cohen, Jennifer
AU - Adimora, Adaora A.
AU - Haddad, Lisa B.
AU - Fischl, Margaret
AU - Cunningham, Sarah
AU - Golub, Elizabeth T.
N1 - Funding Information:
The WIHS, funded by the National Institutes of Health, is the largest prospective cohort study of HIV-seropositive and HIV-seronegative women in the U.S.36,37 HIV-seropositive participants are representative of U.S. WLHIV in demographics and HIV risk profile.36
Funding Information:
The MACS/WIHS Combined Cohort Study (MWCCS) is funded primarily by the National Heart, Lung, and Blood Institute (NHLBI), with additional co-funding from the Eu-nice Kennedy Shriver National Institute of Child Health & Human Development (NICHD), National Human Genome Research Institute (NHGRI), National Institute on Aging (NIA), National Institute of Dental & Craniofacial Research (NIDCR), National Institute of Allergy and Infectious Diseases (NIAID), National Institute of Neurological Disorders and Stroke (NINDS), National Institute of Mental Health (NIMH), National Institute on Drug Abuse (NIDA), National Institute of Nursing Research (NINR), and National Cancer Institute (NCI). MWCCS data collection is also supported by UL1-TR000004 (University of California, San Francisco Clinical and Translational Science Institute), P30-AI-050409 (Atlanta Center for AIDS Research), P30-AI-050410 (University of North Carolina Center for AIDS Research), P30-AI-027767 (University of Alabama at Birmingham Center for AIDS Research), and P30-AI-073961 (Miami Center for AIDS Research). S.K. was supported as a KL2 scholar by the National Center for Advancing Translational Sciences of the National Institutes of Health (KL2-TR-001432). L.B.H.’s effort was supported by the National Institute of Health, Eunice Kennedy Shriver Institute of Child Health and Human Development (NICHD-K23-HD-078153). M.R.D.’s effort was supported by the NIDA (R03-DA-03569102).
PY - 2020/10/1
Y1 - 2020/10/1
N2 - Background: Our objectives were to estimate the association of gender-based violence (GBV) experience with the risk of sexually transmitted infection (STI) acquisition in HIV-seropositive and HIV-seronegative women, to compare the STI risks associated with recent and lifetime GBV exposures, and to quantify whether these associations differ by HIV status. Methods: We conducted a multicenter, prospective cohort study in the Women's Interagency HIV Study, 1994- 2018. Poisson models were fitted using generalized estimating equations to estimate the association of past 6-month GBV experience (physical, sexual, or intimate partner psychological violence) with subsequent self-reported STI diagnosis (gonorrhea, syphilis, chlamydia, pelvic inflammatory disease, or trichomoniasis). Results: Data from 2868 women who reported recent sexual activity comprised 12,069 person-years. Higher STI risk was observed among HIV-seropositive women (incidence rate [IR] 5.5 per 100 person-years) compared with HIV-seronegative women (IR 4.3 per 100 person-years). Recent GBV experience was associated with a 1.28-fold (95% confidence interval [CI] 0.99, 1.65) risk after adjustment for HIV status and relevant demographic, socioeconomic, and sexual risk variables. Other important risk factors for STI acquisition included unstable housing (adjusted incidence rate ratio [AIRR] 1.81, 95% CI 1.32-2.46), unemployment (AIRR 1.42, 95% CI 1.14-1.76), transactional sex (AIRR 2.06, 95% CI 1.52-2.80), and drug use (AIRR 1.44, 95% CI 1.19- 1.75). Recent physical violence contributed the highest risk of STI acquisition among HIV-seronegative women (AIRR 2.27, 95% CI 1.18-4.35), whereas lifetime GBV experience contributed the highest risk among HIVseropositive women (AIRR 1.59, 95% CI 1.20-2.10). Conclusions: GBVprevention remains an important public health goalwith direct relevance towomen's sexual health.
AB - Background: Our objectives were to estimate the association of gender-based violence (GBV) experience with the risk of sexually transmitted infection (STI) acquisition in HIV-seropositive and HIV-seronegative women, to compare the STI risks associated with recent and lifetime GBV exposures, and to quantify whether these associations differ by HIV status. Methods: We conducted a multicenter, prospective cohort study in the Women's Interagency HIV Study, 1994- 2018. Poisson models were fitted using generalized estimating equations to estimate the association of past 6-month GBV experience (physical, sexual, or intimate partner psychological violence) with subsequent self-reported STI diagnosis (gonorrhea, syphilis, chlamydia, pelvic inflammatory disease, or trichomoniasis). Results: Data from 2868 women who reported recent sexual activity comprised 12,069 person-years. Higher STI risk was observed among HIV-seropositive women (incidence rate [IR] 5.5 per 100 person-years) compared with HIV-seronegative women (IR 4.3 per 100 person-years). Recent GBV experience was associated with a 1.28-fold (95% confidence interval [CI] 0.99, 1.65) risk after adjustment for HIV status and relevant demographic, socioeconomic, and sexual risk variables. Other important risk factors for STI acquisition included unstable housing (adjusted incidence rate ratio [AIRR] 1.81, 95% CI 1.32-2.46), unemployment (AIRR 1.42, 95% CI 1.14-1.76), transactional sex (AIRR 2.06, 95% CI 1.52-2.80), and drug use (AIRR 1.44, 95% CI 1.19- 1.75). Recent physical violence contributed the highest risk of STI acquisition among HIV-seronegative women (AIRR 2.27, 95% CI 1.18-4.35), whereas lifetime GBV experience contributed the highest risk among HIVseropositive women (AIRR 1.59, 95% CI 1.20-2.10). Conclusions: GBVprevention remains an important public health goalwith direct relevance towomen's sexual health.
KW - HIV
KW - Intimate partner violence
KW - Physical violence
KW - Sexual violence
KW - Sexually transmitted infections
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U2 - 10.1089/jwh.2019.7972
DO - 10.1089/jwh.2019.7972
M3 - Article
C2 - 32996812
AN - SCOPUS:85093705499
VL - 29
SP - 1256
EP - 1267
JO - Journal of Women's Health
JF - Journal of Women's Health
SN - 1540-9996
IS - 10
ER -