Carolina Population Center, University of North Carolina, 123 W Franklin St. Chapel Hill, Chapel Hill, NC, 27599, USA.
Department of Health Sciences, Northeastern University, Boston, MA, USA.
AIDS Behav. 2019 Nov;23(11):2946-2955. doi: 10.1007/s10461-019-02611-8.
Transactional sex is associated with socioeconomic disadvantage and HIV risk but few studies in the United States (US) have examined both individual and area-level predictors of transactional sex or distinguished transactional sex from sex work. We combined data from HIV Prevention Trials Network 064 study and the US Census to estimate prevalence ratios (PR) for the relationship between census-level and individual measures of economic deprivation and housing instability on transactional sex in 417 women in North Carolina. Increased transactional sex was associated with food insecurity (PR 1.86; 95%; CI 1.57, 2.19), housing instability (PR 1.33; 95% CI 1.11, 1.59), substance abuse (PR 1.90; 95% CI 1.64, 2.19) and partner incarceration (PR 1.32; 95% CI 1.09, 1.61). Census-level indicators were not associated with transactional sex, adjusted for individual-level covariates. Interventions should support housing stability and financial opportunities among southern African American women to reduce HIV risk, particularly among women with incarcerated partners.
交易性行为与社会经济劣势和 HIV 风险相关,但在美国(US),很少有研究同时检验交易性行为的个体和区域预测因素,或区分交易性行为与性工作。我们结合了 HIV 预防试验网络 064 研究和美国人口普查的数据,以估计北卡罗来纳州 417 名女性中,普查层面和个体经济贫困和住房不稳定指标与交易性行为之间的关系的患病率比(PR)。食物不安全(PR 1.86;95%CI 1.57,2.19)、住房不稳定(PR 1.33;95%CI 1.11,1.59)、物质滥用(PR 1.90;95%CI 1.64,2.19)和伴侣监禁(PR 1.32;95%CI 1.09,1.61)与交易性行为增加相关。在调整了个体层面的协变量后,普查层面的指标与交易性行为无关。干预措施应支持南部非裔美国妇女的住房稳定和经济机会,以降低 HIV 风险,特别是对于有被监禁伴侣的妇女。