Surratt H L, Inciardi J A, Weaver J C, Falú V M
Center for Drug and Alcohol Studies, University of Delaware, Coral Gables, FL 33134, USA.
AIDS Care. 2005 Jun;17 Suppl 1:S26-35. doi: 10.1080/09540120500121151.
In the US Virgin Islands 575 cases of AIDS had been reported to the Centers for Disease Control and Prevention through mid-2003. Although males continue to be most affected by HIV/AIDS, the feminization of the epidemic is evidenced by recent data showing rates of infection increasing rapidly among women. This paper focuses on the role of substance abuse and the socially and culturally based gender issues that influence risk and vulnerability to HIV in this setting. 254 chronically drug- or alcohol-involved men and women were recruited and interviewed using targeted sampling strategies. Crack use was overwhelmingly reported by females when compared to males (84.7% vs. 48.8%). Women also reported a significantly higher number of sexual partners in the past month (5.6 vs. 2.3) and significantly more occasions of unprotected vaginal sexual contact (11.2 vs. 6.5). Rates of self-reported HIV infection were elevated among women as well (8.8% vs. 1.4%). Women's precarious economic position and lack of access to legitimate income-generating activities tended to drive them into 'survival sex' to support their subsistence and drug needs. As such, it would appear that substance abuse has an emerging role in the spread of the epidemic in St. Croix, particularly among women.
截至2003年年中，美属维尔京群岛已向疾病控制与预防中心报告了575例艾滋病病例。尽管男性仍然是受艾滋病毒/艾滋病影响最严重的群体，但最近的数据显示女性感染率迅速上升，这表明该流行病正在女性化。本文重点关注药物滥用的作用以及基于社会和文化的性别问题，这些问题在这种情况下会影响感染艾滋病毒的风险和易感性。采用有针对性的抽样策略，招募并采访了254名长期吸毒或酗酒的男性和女性。与男性相比，女性吸食强效可卡因的比例极高（84.7%对48.8%）。女性报告的过去一个月内的性伴侣数量也显著更多（5.6个对2.3个），以及无保护阴道性接触的次数也显著更多（11.2次对6.5次）。自我报告的艾滋病毒感染率在女性中也有所升高（8.8%对1.4%）。女性不稳定的经济状况以及缺乏合法的创收活动，往往促使她们从事“生存性性行为”以维持生计和满足毒品需求。因此，药物滥用在圣克罗伊岛的疫情传播中似乎正发挥着越来越大的作用，尤其是在女性当中。
