在美国注射毒品的人群中感知HIV耻辱的预测因素。

IF 4 2区社会学 Q1 SUBSTANCE ABUSE

Harm Reduction Journal Pub Date : 2025-08-30 DOI:10.1186/s12954-025-01285-x

Itunu Sokale, Paige Wermuth, Johnny Wilkerson, Folefac Atem, Salma Khuwaja, Catherine Troisi

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We created a composite PHS index score by summing each participant's four measures of PHS and categorizing participants based on whether their score was above or below the mean PHS index score. Adjusted prevalence ratios (aPR) and 95% CI were calculated using the generalized linear model Poisson regression log-link function to assess the predictors of PHS.Results: A total of 10,925 (10,229 HIV-negative, 179 HIV-positive-unaware, and 517 HIV-positive-aware) PWID were assessed. PHS prevalence was similar (52.6%, 53.4%, 53.6%) across groups, but the predictors differed by HIV status. 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Among HIV-positive-aware PWID, PHS predictors included younger age (30-39 years: (aPR 1.28, 95% CI: 1.01-1.62), female sex (aPR 1.28, 95% CI: 1.05-1.55), Hispanic race/ethnicity (aPR 1.52, 95% CI: 1.23-1.89), incarceration (aPR 1.32, 95% CI: 1.10-1.56), and past-year SSP participation (aPR 0.84, 95% CI: 0.74-0.96).Conclusions: PHS predictors differed by HIV status. 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引用次数: 0

摘要

背景：艾滋病毒污名是结束艾滋病毒流行的巨大障碍。为了制定有效的艾滋病毒干预措施，我们必须确定与艾滋病毒耻辱相关的因素，特别是在注射吸毒者等高危群体中。我们的目的是在来自美国23个城市的PWID样本中确定感知HIV耻辱（PHS）的预测因素。方法：对2018年全国≥18岁PWID艾滋病行为监测数据进行分析。小灵通是通过一项有效的调查来评估的，该调查测量了小灵通的四个构念：感知不友好、感知歧视、感知惩罚和感知支持。我们通过将每个参与者的四项小灵通指标相加，并根据他们的得分高于或低于小灵通指数平均得分对参与者进行分类，从而创建了一个综合小灵通指数得分。采用广义线性模型泊松回归log-link函数计算调整患病率比（aPR）和95% CI，以评估小灵通的预测因子。结果：共评估了10925例PWID（10229例hiv阴性，179例hiv阳性不知情，517例hiv阳性知情）。各组小灵通患病率相似（52.6%,53.4%,53.6%），但预测因子因HIV感染状况而异。对于hiv阴性组，PHS预测因子为年龄较大（≥50岁：aPR 1:10, 95%可信区间（CI）： 1.01-1.19）、女性（aPR 1.07, 95% CI: 1.03-1.10）、西班牙裔（aPR 1.11, 95% CI: 1.06-1.16）和其他（aPR 1.08, 95% CI: 1.02-1.14）、种族/民族、无家可归（aPR 1.07, 95% CI: 1.03-1.10）、共用注射器（aPR 1.09, 95% CI: 1.03- 1.13）、参与吸毒治疗（aPR 0.96, 95% CI: 0.93-0.99）、注射器服务计划（aPR 0.94, 95% CI: 1.01-1.19）。0.91-0.97)，访谈前12个月内未进行HIV检测（aPR 1.07, 95% CI: 1.03-1.10）。对于未意识到艾滋病毒阳性的PWID，过去一年的无家可归（aPR 2.23, 95% CI: 1.46-1.3.40）和监禁（aPR 0.71, 95% CI: 0.57-0.89）与小灵通有关。在艾滋病毒阳性意识的PWID中，PHS预测因子包括年龄较小（30-39岁）（aPR 1.28, 95% CI: 1.01-1.62）、女性（aPR 1.28, 95% CI: 1.05-1.55）、西班牙裔种族/民族（aPR 1.52, 95% CI: 1.23-1.89）、监禁（aPR 1.32, 95% CI: 1.10-1.56）和过去一年参与SSP （aPR 0.84, 95% CI: 0.74-0.96）。结论：PHS预测因子因HIV感染状况而异。目前的研究结果强调了利用SSP和药物使用治疗有效对抗艾滋病毒污名的重要性。

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Predictors of perceived HIV stigma among people who inject drugs in the United States.

Background: HIV stigma is a huge impediment to ending the HIV epidemic. To develop effective HIV interventions, we must determine factors associated with HIV stigma, particularly among high-risk groups like people who inject drugs (PWID). We aimed to identify predictors of perceived HIV stigma (PHS) among a sample of PWID from 23 U.S. cities.

Methods: We analyzed the 2018 National HIV Behavioral Surveillance data on PWID aged ≥ 18 years. PHS was assessed using a validated survey that measured four PHS constructs: perceived unfriendliness, perceived discrimination, perceived punishment, and perceived support. We created a composite PHS index score by summing each participant's four measures of PHS and categorizing participants based on whether their score was above or below the mean PHS index score. Adjusted prevalence ratios (aPR) and 95% CI were calculated using the generalized linear model Poisson regression log-link function to assess the predictors of PHS.

Results: A total of 10,925 (10,229 HIV-negative, 179 HIV-positive-unaware, and 517 HIV-positive-aware) PWID were assessed. PHS prevalence was similar (52.6%, 53.4%, 53.6%) across groups, but the predictors differed by HIV status. For HIV-negative group, PHS predictors were older age (≥ 50 years: aPR 1:10, 95% confidence interval (CI): 1.01-1.19), female sex (aPR 1.07, 95% CI: 1.03-1.10), Hispanic (aPR 1.11, 95% CI: 1.06-1.16) and Other (aPR 1.08, 95% CI: 1.02-1.14) race/ethnicity, homelessness (aPR 1.07, 95% CI: 1.03-1.10), receptive syringe sharing (aPR 1.09, 95% CI: 1.05-1.13), participation in drug use treatment (aPR 0.96, 95% CI: 0.93-0.99), syringe service program (SSP) (aPR 0.94, 95% CI: 0.91-0.97), and no HIV testing (aPR 1.07, 95% CI: 1.03-1.10) within 12 month before the interview. For HIV-positive-unaware PWID, past-year homelessness (aPR 2.23, 95% CI: 1.46-1.3.40) and incarceration (aPR 0.71, 95% CI: 0.57-0.89) were linked with PHS. Among HIV-positive-aware PWID, PHS predictors included younger age (30-39 years: (aPR 1.28, 95% CI: 1.01-1.62), female sex (aPR 1.28, 95% CI: 1.05-1.55), Hispanic race/ethnicity (aPR 1.52, 95% CI: 1.23-1.89), incarceration (aPR 1.32, 95% CI: 1.10-1.56), and past-year SSP participation (aPR 0.84, 95% CI: 0.74-0.96).

Conclusions: PHS predictors differed by HIV status. The current findings highlight the importance of leveraging SSP and drug use treatment to combat HIV stigma effectively.

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来源期刊

Harm Reduction Journal Medicine-Public Health, Environmental and Occupational Health

CiteScore

5.90

自引率

9.10%

发文量

126

审稿时长

26 weeks

期刊介绍： Harm Reduction Journal is an Open Access, peer-reviewed, online journal whose focus is on the prevalent patterns of psychoactive drug use, the public policies meant to control them, and the search for effective methods of reducing the adverse medical, public health, and social consequences associated with both drugs and drug policies. We define "harm reduction" as "policies and programs which aim to reduce the health, social, and economic costs of legal and illegal psychoactive drug use without necessarily reducing drug consumption". We are especially interested in studies of the evolving patterns of drug use around the world, their implications for the spread of HIV/AIDS and other blood-borne pathogens.