HIV Center for Clinical and Behavioral Studies, New York State Psychiatric Institute and Columbia University, New York, New York, United States of America.
PLoS One. 2013;8(1):e53552. doi: 10.1371/journal.pone.0053552. Epub 2013 Jan 9.
Even though women who have sex with women are usually understood to be at no or very low risk for HIV infection, we explored whether lesbian and bisexual women in a geographical area with high HIV prevalence (Southern Africa) get tested for HIV and whether, among those women who get tested, there are women who live with HIV/AIDS. The study was conducted in collaboration with community-based organizations in Botswana, Namibia, South Africa and Zimbabwe. Data were collected via written surveys of women who in the preceding year had had sex with a woman (18 years and older; N = 591). Most participating women identified as lesbian and black. Almost half of the women (47.2%) reported ever having had consensual heterosexual sex. Engagement in transactional sex (lifetime) was reported by 18.6% of all women. Forced sex by men or women was reported by 31.1% of all women. A large proportion of the women reported to ever have been tested for HIV (78.3%); number of lifetime female and male partners was independently associated with having been tested; women who had engaged in transactional sex with women only or with women and men were less likely to have been tested. Self-reported HIV prevalence among tested women who knew their serostatus was 9.6%. Besides age, the sole independent predictor of a positive serostatus was having experienced forced sex by men, by women, or by both men and women. Study findings indicate that despite the image of invulnerability, HIV/AIDS is a reality for lesbian and bisexual women in Southern Africa. Surprisingly, it is not sex with men per se, but rather forced sex that is the important risk factor for self-reported HIV infection among the participating women. HIV/AIDS policy should also address the needs of lesbian, bisexual and other women who have sex with women.
尽管通常认为与女性发生性行为的女性感染艾滋病毒的风险很低或没有风险，但我们探讨了在艾滋病毒高发地区（南部非洲）的女同性恋和双性恋女性是否接受艾滋病毒检测，以及在接受检测的女性中，是否有感染艾滋病毒/艾滋病的女性。该研究是与博茨瓦纳、纳米比亚、南非和津巴布韦的社区组织合作进行的。数据是通过对过去一年与女性发生过性行为（18 岁及以上；N=591）的女性进行书面调查收集的。大多数参与研究的女性自认为是女同性恋者和黑人。近一半的女性（47.2%）报告曾有过自愿的异性性行为。所有女性中有 18.6%报告有过性交易行为（终身）。所有女性中有 31.1%报告曾遭受过男性或女性的强迫性行为。很大一部分女性报告曾接受过艾滋病毒检测（78.3%）；女性一生中女性和男性伴侣的数量与接受检测的情况独立相关；仅与女性发生过性交易或与女性和男性发生过性交易的女性接受检测的可能性较低。报告知晓自己艾滋病毒感染状况的接受过检测的女性中，自我报告的艾滋病毒感染率为 9.6%。除了年龄之外，唯一独立预测艾滋病毒阳性的因素是曾遭受过男性、女性或男女双方的强迫性行为。研究结果表明，尽管女同性恋和双性恋女性形象上不易感染艾滋病毒/艾滋病，但在南部非洲，艾滋病毒/艾滋病确实是她们面临的一个现实问题。令人惊讶的是，导致参与研究的女性自我报告感染艾滋病毒的重要风险因素不是与男性发生性行为，而是强迫性行为。艾滋病毒/艾滋病政策还应解决女同性恋、双性恋和其他与女性发生性行为的女性的需求。
