1 Division of HIV/AIDS Prevention, National Center for HIV, Hepatitis, STD and TB Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia .
2 ICF International at the Division of HIV/AIDS Prevention, National Center for HIV, Hepatitis, STD and TB Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia .
J Womens Health (Larchmt). 2017 Nov;26(11):1150-1160. doi: 10.1089/jwh.2016.6224. Epub 2017 May 30.
In 2014, women represented 19% of HIV diagnoses in the United States. Of these, 78% were among black women and Latinas. Sexual risk behaviors-for example concurrent sex partnerships, nonmonogamous sex partners, and inconsistent condom use-are associated with increased HIV transmission and prevalence; these behaviors have been understudied, collectively, in women.
To examine HIV-related sexual risk behaviors among sexually active women aged 18-44 years by race/ethnicity and over time, we used data from the 2006-2008, 2008-2010, and 2011-2013 cycles of the National Survey of Family Growth. We estimated weighted percentages and performed logistic regression to measure adjusted prevalence ratios (aPR) and 95% confidence intervals (CI) for associations between selected behaviors and sociodemographic covariates.
Among 13,588 women, 1.1% reported concurrent sex partnerships, 10.3% reported male partners whom they perceived were nonmonogamous, and 21.1% reported using a condom at either last vaginal or anal sex. Black women (aPR = 1.52; CI = 1.36-1.71) and Latinas (aPR = 1.29; CI = 1.14-1.47) were more likely to report condom use at either last vaginal or anal sex compared with white women. However, black women were also more likely to report concurrent opposite-sex partnerships (aPR = 2.44; CI = 1.57-3.78) and perceived nonmonogamous sex partners (aPR = 1.33; CI = 1.14-1.56) compared with white women.
Improved HIV behavioral risk-reduction strategies are needed for women. Black women could benefit from interventions that address partnership concurrency. For black women and Latinas, who are more likely to use condoms, further examination of broader social and structural factors as contributors to racial/ethnic gaps are warranted and vital for understanding and decreasing HIV-related disparities.
2014 年，美国女性艾滋病诊断病例占比 19%。其中，78%为黑人女性和拉丁裔女性。性风险行为，例如同时存在多个性伴侣、非单一性伴侣和不坚持使用安全套，与艾滋病病毒传播和流行率的增加有关；这些行为在女性中总体上研究不足。
为了按种族/族裔和时间来研究 18-44 岁有性行为的女性的艾滋病相关性行为风险，我们使用了 2006-2008 年、2008-2010 年和 2011-2013 年全国家庭增长调查的数据。我们估计了加权百分比，并进行了逻辑回归，以衡量选定行为与社会人口统计学协变量之间的关联的调整后患病率比(aPR)和 95%置信区间(CI)。
在 13588 名女性中，1.1%报告了同时存在多个性伴侣，10.3%报告了她们认为非单一性伴侣的男性伴侣，21.1%报告了在最近一次性阴道或肛门性行为中使用了安全套。与白人女性相比，黑人女性(aPR=1.52；CI=1.36-1.71)和拉丁裔女性(aPR=1.29；CI=1.14-1.47)更有可能报告在最近一次性阴道或肛门性行为中使用了安全套。然而，黑人女性也更有可能报告同时存在异性性伴侣(aPR=2.44；CI=1.57-3.78)和被认为是非单一性伴侣的性伴侣(aPR=1.33；CI=1.14-1.56)，与白人女性相比。
需要为女性制定更好的艾滋病行为风险降低策略。黑人女性可能受益于解决伴侣关系同时存在的干预措施。对于更有可能使用安全套的黑人女性和拉丁裔女性，进一步研究更广泛的社会和结构性因素对种族/族裔差距的贡献是必要的，对于理解和减少与艾滋病相关的差异至关重要。
