Nerlander Lina M, Hess Kristen L, Rose Charles E, Sionean Catlainn, Thorson Anna, Broz Dita, Paz-Bailey Gabriela
*Division of HIV/AIDS prevention, Centers for Disease Control and Prevention, Atlanta, GA; and †Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden.
J Acquir Immune Defic Syndr. 2017 Jul 1;75 Suppl 3(Suppl 3):S333-S340. doi: 10.1097/QAI.0000000000001408.
Women who inject drugs and who also exchange sex are at increased risk for HIV infection, but data on this population in the United States remain sparse.
This study assessed the prevalence of exchanging sex for money or drugs among women who inject drugs using data from the 2009 US National HIV Behavioral Surveillance (NHBS) system. Prevalence of being HIV-positive (testing positive in NHBS), HIV-positive-unaware (reporting being HIV-negative or unknown status but testing positive in NHBS), and risk behaviors and use of services were compared between women who did and did not exchange sex. The association between exchange sex and being HIV-positive-unaware of the infection was examined using multivariate Poisson models with robust standard errors.
Among 2305 women who inject drugs, 39% reported receiving things like money or drugs from ≥1 male partners in exchange for oral, vaginal, or anal sex in the previous 12 months. Women who exchanged sex were more likely to be unemployed, homeless, lack health insurance, have multiple condomless vaginal or anal sex partners, and receptively share syringes. In multivariate analysis, exchange sex was associated with being HIV-positive-unaware (adjusted prevalence ratio 1.97, 95% confidence intervals: 1.31 to 2.97).
Prevalence of exchange sex was high in this population. Women who exchange sex were more likely to be socially disadvantaged, report sexual and injection risk, and be HIV-positive-unaware. They represent an important group to reach with HIV prevention, testing, and care services.
注射毒品且有性交易行为的女性感染艾滋病毒的风险更高，但美国关于这一人群的数据仍然稀少。
本研究利用2009年美国国家艾滋病毒行为监测（NHBS）系统的数据，评估了注射毒品女性中以性交易换取金钱或毒品的流行情况。比较了有性交易和无性交易的女性之间艾滋病毒呈阳性（在NHBS检测呈阳性）、未意识到自己艾滋病毒呈阳性（报告自己艾滋病毒呈阴性或状况未知但在NHBS检测呈阳性）的流行情况，以及风险行为和服务使用情况。使用具有稳健标准误差的多变量泊松模型检验了性交易与未意识到自己感染艾滋病毒呈阳性之间的关联。
在2305名注射毒品的女性中，39%报告在过去12个月里从≥1名男性伴侣那里获得金钱或毒品等物品以换取口交、阴道性交或肛交。有性交易的女性更有可能失业、无家可归、没有医疗保险、有多个无保护措施的阴道或肛交性伴侣，并且共用注射器。在多变量分析中，性交易与未意识到自己感染艾滋病毒呈阳性有关（调整后的患病率比值为1.97，95%置信区间：1.31至2.97）。
这一人群中性交易的流行率很高。有性交易的女性更有可能处于社会弱势地位，报告有性传播和注射相关风险，并且未意识到自己感染艾滋病毒呈阳性。她们是艾滋病毒预防、检测和护理服务的重要目标人群。
