Sexual Risk Behavior and Lifetime HIV Testing: The Role of Adverse Childhood Experiences.

Despite the success of HIV prevention drugs such as PrEP, HIV incident transmission rates remain a significant problem in the United States. A life-course perspective, including experiences of childhood adversity, may be useful in addressing the HIV epidemic. This paper used 2019 BRFSS data to elucidate the role that childhood adversity plays in the relationship between HIV risk and HIV testing. Participants (n = 58,258) completed self-report measures of HIV risk behaviors, HIV testing, and adverse childhood experiences (ACEs). The median number ACEs in the sample was 1, with verbal abuse (33.9%), and parental separation (31.3%) being the most common ACEs reported. Bivariate findings showed that all ACEs were associated with increased HIV risk and testing. However, increased risk was not correlated with increased HIV testing, with the highest incongruence related to mental health problems of household member (53.48%). While both self-reported HIV risk and ACEs were positively associated with HIV testing, their interaction had a negative association with testing (aPR = 0.51, 95%CI 0.42, 0.62). The results highlight the need for targeted HIV prevention strategies for at-risk individuals with a history of childhood adversity.

尽管像暴露前预防（PrEP）这类艾滋病预防药物取得了成功，但在美国，艾滋病的意外传播率仍然是一个重大问题。从生命历程的角度，包括童年不良经历，可能有助于应对艾滋病的流行。本文利用2019年行为风险因素监测系统（BRFSS）的数据来阐明童年不良经历在艾滋病风险与艾滋病检测之间的关系中所起的作用。参与者（n = 58258）完成了关于艾滋病风险行为、艾滋病检测以及童年不良经历（ACEs）的自我报告测量。样本中童年不良经历的中位数为1，其中言语虐待（33.9%）和父母分居（31.3%）是报告中最常见的童年不良经历。双变量研究结果显示，所有童年不良经历都与艾滋病风险增加和检测增加有关。然而，风险增加与艾滋病检测增加并不相关，其中与家庭成员心理健康问题相关的不一致性最高（53.48%）。虽然自我报告的艾滋病风险和童年不良经历都与艾滋病检测呈正相关，但它们的相互作用与检测呈负相关（调整患病率比 = 0.51，95%置信区间为0.42 - 0.62）。研究结果强调了针对有童年不良经历史的高危个体制定有针对性的艾滋病预防策略的必要性。