Socioecological factors influencing women’s HIV risk in the United States: qualitative findings from the women’s HIV SeroIncidence study (HPTN 064)

Frew, Paula M.; Parker, Kimberly A.; Vô, Linda Trinh; Haley, Danielle F.; O’Leary, Ann; Diallo, Dázon Dixon; Golin, Carol E.; Kuo, Irene; Soto-Torres, Lydia; Wang, Jing; Adimora, Adaora A.; Randall, Laura; Rı́o, Carlos del; Hodder, Sally

doi:10.1186/s12889-016-3364-7

Cited by 54 publications

(48 citation statements)

References 83 publications

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“…The incidence of HIV in the United States (U.S.) has remained stable in the past few years and HIV diagnoses among women have been in decline [1]. However, certain subpopulations of women (e.g., women of color, women with low income or low education, and women who inject drugs) are still at considerable risk for HIV [2]. Research on social and structural forces that increase vulnerability for HIV and other sexually transmitted infections (STIs) among women has demonstrated that a multitude of factors, including minority status, low socioeconomic status (SES), and adverse experiences, intersect to create milieus of risk where women, especially women of color, are at a disadvantage when it comes to avoiding HIV and STI [2,3].…”

Section: Introductionmentioning

confidence: 99%

Prevalence and correlates of transactional sex among women of low socioeconomic status in Portland, OR

et al. 2020

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Background Women who report transactional sex are at increased risk for HIV and other sexually transmitted infections (STIs). However, in the United States, social, behavioral, and trauma-related vulnerabilities associated with transactional sex are understudied and data on access to biomedical HIV prevention among women who report transactional sex are limited. Methods In 2016, we conducted a population-based, cross-sectional survey of women of low socioeconomic status recruited via respondent-driven sampling in Portland, Oregon. We calculated the prevalence and, assessed the correlates of, transactional sex using generalized linear models accounting for sampling design. We also compared health outcomes, HIV screening, and knowledge and uptake of HIV pre-exposure prophylaxis (PrEP) between women who did and did not report transactional sex. Results Of 334 women, 13.6% reported transactional sex (95% confidence interval [CI]: 6.8, 20.5%). Women who reported transactional sex were older, more likely to identify as black, to identify as lesbian or bisexual, to experience childhood trauma and recent sexual violence, and to have been homeless. Six percent (95% CI: 1.8, 10.5%) of women with no adverse childhood experiences (ACEs) reported transactional sex compared to 23.8% (95% CI: 13.0, 34.6%) of women who reported eleven ACEs (P < 0.001). Transactional sex was strongly associated with combination methamphetamine and opiate use as well as condomless sex. Women who reported transactional sex were more likely to report being diagnosed with a bacterial STI and hepatitis C; however, HIV screening and pre-exposure prophylaxis knowledge and use were low. Conclusions In a sample of women of low socioeconomic status in Portland, Oregon, transactional sex was characterized by marginalized identities, homelessness, childhood trauma, sexual violence, substance use, and sexual vulnerability to HIV/STI. Multi-level interventions that address these social, behavioral, and trauma-related factors and increase access to biomedical HIV prevention are critical to the sexual health of women who engage in transactional sex.

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Section: Introductionmentioning

confidence: 99%

Prevalence and correlates of transactional sex among women of low socioeconomic status in Portland, OR

et al. 2020

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“…Other factors identified were food insecurity, partner age >35, intimate partner violence (IPV), partner's sexual concurrency with multiple women, prevalence of substance abuse, and sex exchange for financial and in-kind resources in their communities. 30 …”

Section: Resultsmentioning

confidence: 99%

Optimizing Delivery of HIV Preexposure Prophylaxis for Women in the United States

Aaron

Blum

Seidman

et al. 2018

AIDS Patient Care and STDs

117

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Preexposure prophylaxis (PrEP) is a highly effective HIV prevention method; however, it is underutilized among women who are at risk for acquisition of HIV. Women comprise one in five HIV diagnoses in the United States, and significant racial disparities in new HIV diagnoses persist. The rate of new HIV diagnoses among black and African American women in 2015 was 16 times greater than that of white women. These disparities highlight the importance of HIV prevention strategies for women, including the use of PrEP. PrEP is the first highly effective HIV prevention method available to women that is entirely within their control. However, because so few women who may benefit from PrEP are aware of it, few women's healthcare providers offer PrEP to their patients, PrEP has not yet achieved its potential to reduce HIV infections in women. This article describes individual and systemic barriers for women related to the uptake of PrEP services; explains how providers can identify women at risk for HIV; reviews how to provide PrEP to women; and outlines client-centered models for HIV prevention services. Better access to culturally acceptable and affordable medical and social services may offer support to women for consistent and ongoing use of PrEP. This discussion may be used to inform HIV prevention activities for women and guide interventions to decrease racial/ethnic disparities in rates of HIV infection among US women.

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“…The distribution of asymptomatic sexually transmitted infections varies worldwide, and studies have shown that social, economic and behavioral conditions influence their epidemiology [ 4 , 5 ]. Therefore, in general, higher prevalences of HIV, syphilis, and hepatitis B and C have been found in low- and middle-income countries compared to developed countries [ 4 , 6 ].…”

Section: Introductionmentioning

confidence: 99%

Epidemiology of HIV, syphilis, and hepatitis B and C among manual cane cutters in low-income regions of Brazil

et al. 2018

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BackgroundIn recent decades the epidemic of asymptomatic sexually transmitted infections has extended deep into Brazil, including small towns and rural areas. The purpose of this study was to investigate the epidemiology of HIV, syphilis, and hepatitis B (HBV) and hepatitis C viruses (HCV), and to evaluate immunization coverage against hepatitis B in a group of rural workers in Brazil.MethodsIn 2016, a cross-sectional study was conducted with 937 manual sugarcane cutters of the Midwest and Northeast Regions of Brazil. All individuals were interviewed and screened for HIV, syphilis, HBV and HCV. Correlating factors with lifetime HBV infection were investigated using logistic regression. Positive Predictive Values, Negative Predictive Values, sensitivity and specificity were also calculated relative to vaccination against Hepatitis B, comparing anti-HBs titers to vaccination reports.ResultsMost reported previous hospitalization (55%), occupational injuries (54%), sharing of personal items (45.8%), alcohol consumption (77.2%), multiple sexual partners in previous 12 months (39.8%), and no condom use during sexual intercourse in last 12 months (46.5%). Only 0.2% reported using injection drugs. Anti-HIV-1 was detected in three individuals (0.3%). Serological markers of lifetime syphilis (treponemal test) were detected in 2.5% (95% CI: 1.6–3.6) of participants, and active syphilis (treponemal test and VDRL) present in 1.2%. No samples were positive for anti-HCV. The prevalence of lifetime HBV infection (current or past infection) was 15.9%, and 0.7% (95% CI 0.4 to 1.5) were HBsAg-positive. Previous hospitalization (OR 1.53, CI 1.05–2.24, p < 0.01) and multiple sexual partners in the last 12 months (OR 1.80, CI 1.25–2.60, p < 0.01) were predictors for lifetime HBV infection. Although 46.7% (95% CI 43.4–49.9) of individuals reported having been vaccinated against hepatitis B, only 20.6% (95% CI 18.1–23.3) showed serological evidence of previous hepatitis B vaccination (positive for anti-HBs alone).ConclusionsThe high prevalence of syphilis and HBV compared to the general population and the high frequency of risk behaviors show the potential for sexual and parenteral dissemination of these agents in this rural population. In addition, the low frequency of hepatitis B vaccinated individuals suggests a need for improved vaccination services.

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Socioecological factors influencing women’s HIV risk in the United States: qualitative findings from the women’s HIV SeroIncidence study (HPTN 064)

Cited by 54 publications

References 83 publications

Prevalence and correlates of transactional sex among women of low socioeconomic status in Portland, OR

Prevalence and correlates of transactional sex among women of low socioeconomic status in Portland, OR

Optimizing Delivery of HIV Preexposure Prophylaxis for Women in the United States

Epidemiology of HIV, syphilis, and hepatitis B and C among manual cane cutters in low-income regions of Brazil

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