Division of HIV/AIDS Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, GA; Epidemic Intelligence Service, Office of Workforce and Career Development, Centers for Disease Control and Prevention, Atlanta, GA.
Division of STD Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, GA.
Am J Obstet Gynecol. 2018 Oct;219(4):383.e1-383.e7. doi: 10.1016/j.ajog.2018.08.026. Epub 2018 Aug 23.
In 2016, 19% of HIV diagnoses were in women. About 40% of HIV infections in women aged 18-34 years have been attributed to anal sex, suggesting that women who report high risk behaviors such as anal sex might benefit from HIV testing and prevention with preexposure prophylaxis (PrEP). In this analysis, we estimated HIV testing rates among women who reported anal sex.
We analyzed data from the 2011-2015 National Survey of Family Growth to estimate the proportion of sexually active, nonpregnant US women aged 15-44 years who had an HIV test within the past year, stratified by those who reported anal sex and other risk factors, including ≥2 sexual partners, condomless sex with a new partner or multiple partners, gonorrhea in the past year, or any history of syphilis.
Overall, 7.9 million of 42.4 million sexually active, nonpregnant US women (18.7%) reported an HIV test within the past year. Among 42.4 million sexually active women, 9.0 million (20.1%) reported they had anal sex in the past year. Among these 9.0 million women, 19.2% reported that their providers asked about their type of intercourse, and 20.1% reported an HIV test within the past year. Overall, HIV testing was higher among women who reported anal sex and reported that their providers asked about type of sex than those whose provider did not ask (37.8% vs 15.9%; P < .001). HIV testing in the past year was higher for women with other risk behaviors compared with anal sex, ranging from 35.8% to 47.2%.
Overall, HIV testing rates within the past year were low among women with sexual behaviors that increase their risk of acquiring HIV and especially low among those who reported anal sex. Early detection and treatment of HIV, and HIV prevention with PrEP, are effective health services that protect women's health and well-being but that can be offered only based on HIV testing results. Women's health care providers are uniquely poised to assess risk for acquiring HIV, including taking a sexual history that asks about anal sex, and performing HIV testing to identify women who need HIV treatment or might benefit from PrEP.
2016 年，19%的艾滋病诊断病例出现在女性中。在 18-34 岁的女性中，约有 40%的艾滋病毒感染归因于肛交，这表明报告有高危行为（如肛交）的女性可能受益于艾滋病毒检测和预防，包括暴露前预防（PrEP）。在这项分析中，我们估计了报告肛交的女性进行艾滋病毒检测的比例。
我们分析了 2011-2015 年全国家庭增长调查的数据，以估计过去一年中报告有性行为且无妊娠的美国 15-44 岁非孕妇中，有多少人进行了艾滋病毒检测，按报告肛交和其他风险因素（包括≥2 个性伴侣、与新伴侣或多个伴侣无保护性行为、过去一年淋病或任何梅毒史）进行分层。
总体而言，在 4240 万有性行为且无妊娠的美国女性中，有 790 万人（18.7%）在过去一年中接受了艾滋病毒检测。在 4240 万有性行为的女性中，有 900 万人（20.1%）报告在过去一年中进行过肛交。在这 900 万女性中，19.2%的人报告称，她们的提供者询问过她们的性交类型，20.1%的人在过去一年中接受了艾滋病毒检测。总体而言，与没有被医生询问过的女性相比，报告有肛交行为且报告称医生询问过她们的性交类型的女性进行艾滋病毒检测的比例更高（37.8%比 15.9%；P<0.001）。与肛交相比，有其他风险行为的女性在过去一年中进行艾滋病毒检测的比例更高，范围在 35.8%至 47.2%。
总体而言，过去一年中，有增加感染艾滋病毒风险的性行为的女性中，艾滋病毒检测率较低，尤其是报告有肛交行为的女性。艾滋病毒的早期发现和治疗，以及使用 PrEP 进行艾滋病毒预防，是保护妇女健康和福祉的有效卫生服务，但只能基于艾滋病毒检测结果提供。妇女保健提供者是唯一能够评估感染艾滋病毒风险的人，包括询问有关肛交的性史，并进行艾滋病毒检测，以确定需要艾滋病毒治疗或可能受益于 PrEP 的妇女。
