Department of Community Health, Tufts University, Medford, Massachusetts.
The Fenway Institute, Fenway Health, Boston, Massachusetts.
LGBT Health. 2019 Aug/Sep;6(6):306-318. doi: 10.1089/lgbt.2019.0001. Epub 2019 Jul 17.
We examined differences in lifetime human immunodeficiency virus (HIV) testing in relation to both sexual orientation identity and race/ethnicity among U.S. women and men. We used 2013-2017 National Health Interview Survey data and multivariable logistic regression to assess the distribution of lifetime HIV testing across and within sexual orientation identity and racial/ethnic groups of U.S. women ( = 60,867) and men ( = 52,201) aged 18-64 years. Among women, Black lesbian (74.1%) and bisexual (74.0%) women had the highest prevalence whereas Asian lesbian women (32.5%) had the lowest prevalence of lifetime HIV testing. Among men, the prevalence of lifetime HIV testing was the highest among Latino gay men (92.6%) and the lowest among Asian heterosexual men (32.0%). In most cases, Black women and Black and Latino men had significantly higher adjusted odds whereas Asian women and men had lower adjusted odds of lifetime HIV testing compared with their White counterparts within sexual orientation identity groups. In many instances, bisexual women and gay men had significantly higher adjusted odds of lifetime HIV testing relative to their heterosexual counterparts within racial/ethnic groups. Compared with White heterosexual individuals, most sexual orientation identity and racial/ethnic subgroups had significantly higher adjusted odds whereas Asian heterosexual, bisexual, and lesbian women and Asian heterosexual and bisexual men may have lower adjusted odds of lifetime HIV testing. Culturally relevant, linguistically appropriate, and structurally competent programs and practices are needed to facilitate lifetime HIV testing among diverse sexual orientation identity and racial/ethnic subgroups of women and men, including multiply marginalized subgroups that are undertested or disproportionately affected by HIV/AIDS.
我们研究了美国女性和男性在终生人类免疫缺陷病毒（HIV）检测方面的差异，这些差异与性取向认同和种族/民族有关。我们使用了 2013-2017 年国家健康访谈调查数据和多变量逻辑回归来评估美国 18-64 岁女性（=60867 人）和男性（=52201 人）在性取向认同和种族/民族群体内和群体间终生 HIV 检测的分布情况。在女性中，黑人女同性恋者（74.1%）和双性恋者（74.0%）的检测率最高，而亚洲女同性恋者（32.5%）的检测率最低。在男性中，拉丁裔男同性恋者（92.6%）终生 HIV 检测的比例最高，而亚洲异性恋男性（32.0%）的比例最低。在大多数情况下，与性取向认同群体中的白人相比，黑人女性和黑人及拉丁裔男性的调整后终生 HIV 检测的比值比更高，而亚洲女性和男性的调整后比值比更低。在许多情况下，与异性恋者相比，双性恋女性和男同性恋者在种族/民族群体内的终生 HIV 检测的调整后比值比更高。与白人异性恋者相比，大多数性取向认同和种族/民族亚群的调整后比值比更高，而亚洲异性恋、双性恋和女同性恋者以及亚洲异性恋和双性恋男性的调整后比值比可能更低。需要具有文化相关性、语言适当性和结构能力的项目和实践，以促进不同性取向认同和种族/民族的女性和男性群体（包括被严重边缘化的群体）进行终生 HIV 检测，这些群体的检测率较低或受到艾滋病毒/艾滋病的不成比例的影响。
