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<p>Adverse childhood experiences (ACEs) can have lasting, detrimental effects throughout the lifespan and may influence engagement in health care. We conducted a case-cohort study in Tanzania to estimate the association between ACEs and disengagement from HIV care 12 months after initiating antiretroviral therapy (ART) among 217 adults (26 cases and 191 sub-cohort participants). Experiencing one, two, three, and four additional ACEs was significantly associated with 28% (RR<sub>a</sub>= 1.24; 95% CI: 1.05, 1.44; <i>p</i>-value &lt; 0.01), 64% (RR<sub>a</sub>=1.64; 95% CI: 1.22, 2.20), 110% (RR<sub>a</sub>=2.10; 95% CI: 1.35, 3.26), and 168% (RR<sub>a</sub>=2.68; 95% CI: 1.49, 4.38) increases in the risk of disengagement from HIV care, respectively. These findings call for integrated trauma-informed mental health services within HIV care to end HIV/AIDS as a public health threat.</p>

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Adverse childhood experiences and disengagement from HIV care: a case-cohort study in Tanzania

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年6月27日

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  • Sydney Tucker,
  • Solis Winters,
  • Emmanuel Katabaro,
  • Matilda Mlowe,
  • Patrick Bradshaw,
  • Jennifer Ahern,
  • John Colford,
  • Laura Packel,
  • Susan Hillis,
  • Amon Sabasaba,
  • Prosper Njau,
  • Sandra I. McCoy

摘要

Adverse childhood experiences (ACEs) can have lasting, detrimental effects throughout the lifespan and may influence engagement in health care. We conducted a case-cohort study in Tanzania to estimate the association between ACEs and disengagement from HIV care 12 months after initiating antiretroviral therapy (ART) among 217 adults (26 cases and 191 sub-cohort participants). Experiencing one, two, three, and four additional ACEs was significantly associated with 28% (RRa= 1.24; 95% CI: 1.05, 1.44; p-value < 0.01), 64% (RRa=1.64; 95% CI: 1.22, 2.20), 110% (RRa=2.10; 95% CI: 1.35, 3.26), and 168% (RRa=2.68; 95% CI: 1.49, 4.38) increases in the risk of disengagement from HIV care, respectively. These findings call for integrated trauma-informed mental health services within HIV care to end HIV/AIDS as a public health threat.