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Sex Work as a Mediator Between Female Gender and Incident HIV Infection Among People Who Inject Drugs in Tijuana, Mexico.
AIDS and Behavior ( IF 4.852 ) Pub Date : 2020-09-01 , DOI: 10.1007/s10461-020-02828-y Jennifer P Jain 1, 2 , Daniela Abramovitz 1 , Steffanie A Strathdee 1 , Patricia Gonzalez-Zuniga 1 , Gudelia Rangel 3, 4 , Brooke S West 5 , Eileen V Pitpitan 1
AIDS and Behavior ( IF 4.852 ) Pub Date : 2020-09-01 , DOI: 10.1007/s10461-020-02828-y Jennifer P Jain 1, 2 , Daniela Abramovitz 1 , Steffanie A Strathdee 1 , Patricia Gonzalez-Zuniga 1 , Gudelia Rangel 3, 4 , Brooke S West 5 , Eileen V Pitpitan 1
Affiliation
We studied mechanisms driving gender differences in HIV incidence among 651 women and men who inject drugs (PWID) in Tijuana, Mexico, hypothesizing that sex work will mediate the association between female gender and HIV incidence. Of 43 HIV seroconversions occurring between 2011 and 2018, 8.8% were among females and 5.2% among males. HIV incidence density was significantly higher among females versus males (1.75 per 100 person years [PY], 95% CI 1.16-2.66, vs. 0.95 per 100 PY, 95% CI 0.62-1.47). Factors significantly associated with HIV seroconversion were: sex work (adjusted hazard ratio [aHR] = 2.25, 95% CI 1.05-4.80); methamphetamine injection (aHR = 2.30, 95% CI 1.12-4.73); and methamphetamine and heroin co-injection in the past six months (aHR = 2.26, 95% CI 1.23-4.15). In mediation analyses, sex work mediated a substantial proportion (84.3%) of the association between female gender and HIV incidence. Interventions should target female PWID who engage in sex work to reduce gender-related disparities in HIV incidence.
中文翻译:
性工作作为女性性别与墨西哥蒂华纳注射毒品者感染艾滋病毒之间的中介。
我们研究了墨西哥蒂华纳 651 名注射吸毒者 (PWID) 女性和男性 HIV 发病率性别差异的机制,假设性工作将调节女性性别与 HIV 发病率之间的关联。在 2011 年至 2018 年间发生的 43 次 HIV 血清转换中,8.8% 为女性,5.2% 为男性。女性的 HIV 发病密度明显高于男性(1.75/100 人年 [PY],95% CI 1.16-2.66,对比每 100 PY 0.95,95% CI 0.62-1.47)。与 HIV 血清转化显着相关的因素是:性工作(调整后的风险比 [aHR] = 2.25,95% CI 1.05-4.80);甲基苯丙胺注射液(aHR = 2.30,95% CI 1.12-4.73);过去 6 个月内同时注射甲基苯丙胺和海洛因(aHR = 2.26,95% CI 1.23-4.15)。在中介分析中,性工作起到了很大的中介作用(84. 3%) 的女性性别与 HIV 发病率之间的关联。干预措施应针对从事性工作的女性注射吸毒者,以减少与性别相关的 HIV 发病率差异。
更新日期:2020-08-14
中文翻译:
性工作作为女性性别与墨西哥蒂华纳注射毒品者感染艾滋病毒之间的中介。
我们研究了墨西哥蒂华纳 651 名注射吸毒者 (PWID) 女性和男性 HIV 发病率性别差异的机制,假设性工作将调节女性性别与 HIV 发病率之间的关联。在 2011 年至 2018 年间发生的 43 次 HIV 血清转换中,8.8% 为女性,5.2% 为男性。女性的 HIV 发病密度明显高于男性(1.75/100 人年 [PY],95% CI 1.16-2.66,对比每 100 PY 0.95,95% CI 0.62-1.47)。与 HIV 血清转化显着相关的因素是:性工作(调整后的风险比 [aHR] = 2.25,95% CI 1.05-4.80);甲基苯丙胺注射液(aHR = 2.30,95% CI 1.12-4.73);过去 6 个月内同时注射甲基苯丙胺和海洛因(aHR = 2.26,95% CI 1.23-4.15)。在中介分析中,性工作起到了很大的中介作用(84. 3%) 的女性性别与 HIV 发病率之间的关联。干预措施应针对从事性工作的女性注射吸毒者,以减少与性别相关的 HIV 发病率差异。