Violence experience has been consistently associated with HIV risks and substance use behaviors. Although many studies have focused on intimate partner violence (IPV), the role of violence at a structural level (i.e., police abuse) remains relevant for people who inject drugs. This study evaluated the association of IPV and police-perpetrated violence experiences with HIV risk behaviors and substance use in a cohort of HIV-positive people who inject drugs in Ukraine. We also evaluated possible moderation effects of gender and socioeconomic status in the links between violence exposure and HIV risk and polysubstance use behaviors. Data came from the Providence/Boston-CFAR-Ukraine Study involving 191 HIV-positive people who inject drugs conducted at seven addiction treatment facilities in Ukraine. Results from logistic regressions suggest that people who inject drugs and experienced IPV had higher odds of polysubstance use than those who did not experience IPV. Verbal violence and sexual violence perpetrated by police were associated with increased odds of inconsistent condom use. The odds of engaging in polysubstance use were lower for women in relation to police physical abuse. We found no evidence supporting socioeconomic status moderations. Violence experiences were associated with substance use and sexual HIV risk behaviors in this cohort of HIV-positive people who inject drugs in Ukraine. Trauma-informed prevention approaches that consider both individual and structural violence could improve this population’s HIV risks.

暴力经历一直与艾滋病毒风险和药物使用行为相关。尽管许多研究都集中在亲密伴侣暴力 (IPV) 上，但暴力在结构层面上的作用（即警察虐待）仍然与注射吸毒者相关。这项研究评估了乌克兰注射毒品的艾滋病毒阳性人群中 IPV 和警察实施的暴力经历与艾滋病毒危险行为和药物使用之间的关系。我们还评估了性别和社会经济地位在暴力暴露与艾滋病毒风险和多物质使用行为之间的联系中可能产生的调节作用。数据来自普罗维登斯/波士顿-CFAR-乌克兰研究，该研究涉及在乌克兰七个成瘾治疗机构进行的 191 名注射吸毒艾滋病毒呈阳性者。逻辑回归结果表明，注射毒品并经历过 IPV 的人比没有经历过 IPV 的人使用多种物质的几率更高。警察实施的言语暴力和性暴力与不一致使用安全套的可能性增加有关。与警察身体虐待相关的女性使用多种物质的几率较低。我们没有发现任何证据支持社会经济地位的调节。在乌克兰注射吸毒的艾滋病毒阳性人群中，暴力经历与物质使用和性艾滋病毒危险行为有关。考虑到个人暴力和结构性暴力的创伤知情预防方法可以提高该人群的艾滋病毒风险。