HIV Acquisition Among Women From Selected Areas of the United States A Cohort Study
HIV Acquisition Among Women From Selected Areas of the United States A Cohort Study
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DOI：
10.7326/0003-4819-158-1-201301010-00004
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发表时间：
2013-01-01
影响因子：
39.2
通讯作者：
El-Sadr, Wafaa M.
中科院分区：
文献类型：
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作者：
Hodder, Sally L.;Justman, Jessica;El-Sadr, Wafaa M.
背景：在美国新诊断出的 HIV 感染者中，女性占 23%，但最近很少有对美国女性行为特征和 HIV 感染情况进行详细描述的、特征明确的队列。目的：评估居住在 HIV 高流行地区的美国妇女的 HIV 发病率并描述其行为。设计：对基线和每 6 个月进行一次 HIV 快速检测和音频计算机辅助自我访谈的多地点纵向队列妇女进行最多 12 次几个月。 （ClinicalTrials.gov：NCT00995176）地点：位于美国东北部和东南部的 10 个 HIV 患病率和贫困率较高的城市和城郊社区。患者：采用基于场所的抽样方法招募 18 至 44 岁的女性，她们最近发生过无保护性行为，有 1 种或多种其他个人或伴侣风险因素，并且没有自我报告既往 HIV 诊断。测量：HIV 患病率和发病率、HIV 风险频率结果：2099 名高危女性（85.9% 为黑人，11.7% 为西班牙裔）中，32 人（1.5%）在入组时被诊断出感染 HIV。 HIV 年发病率为 0.32%（95% CI，0.14% 至 0.74%）。年龄较大、吸毒和知道伴侣感染艾滋病毒与艾滋病毒感染率有关。研究期间有 10 名女性死亡（每年 0.61%）。 局限性：风险行为的纵向评估仅限于最长 12 个月。很少有艾滋病毒感染事件，因此无法识别艾滋病毒感染的预测特征。结论：这项研究纳入了一组女性，其艾滋病毒发病率远高于美国疾病控制和预防中心对美国黑人女性总人口的国家估计值。需要共同努力，改善类似人群的艾滋病毒预防保健策略和整体健康状况。主要资金来源：美国国立卫生研究院。安实习医生。 2013；158：10-18。
Background: Women account for 23% of newly diagnosed HIV infections in the United States, but there are few recent, well-characterized cohorts of U. S. women in whom behavior characteristics and HIV acquisition have been well-described.Objective: To evaluate HIV incidence and describe behaviors among U. S. women residing in areas of high HIV prevalence.Design: Multisite, longitudinal cohort of women who had HIV rapid testing and audio computer-assisted self-interviews at baseline and every 6 months for up to 12 months. (ClinicalTrials.gov: NCT00995176)Setting: 10 urban and periurban communities with high HIV prevalence and poverty rates, located in the northeastern and southeastern United States.Patients: Venue-based sampling was used to recruit women aged 18 to 44 years who recently had unprotected sex and had 1 or more additional personal or partner risk factors and no self-reported previous HIV diagnosis.Measurements: HIV prevalence and incidence, frequency of HIV risk behaviors, and health status perceptions.Results: Among 2099 high-risk women (85.9% black and 11.7% of Hispanic ethnicity), 32 (1.5%) were diagnosed with HIV infection at enrollment. Annual HIV incidence was 0.32% (95% CI, 0.14% to 0.74%). Older age, substance use, and knowing a partner had HIV were associated with HIV prevalence. Ten women died during the study (0.61% per year).Limitations: Longitudinal assessment of risk behaviors was limited to a maximum of 12 months. There were few incident HIV infections, precluding identification of characteristics predictive of HIV acquisition.Conclusion: This study enrolled a cohort of women with HIV incidence substantially higher than the Centers for Disease Control and Prevention national estimate in the general population of U. S. black women. Concerted efforts to improve preventive health care strategies for HIV and overall health status are needed for similar populations.Primary Funding Source: National Institutes of Health. Ann Intern Med. 2013;158:10-18.