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. 2013 Jan 1;158(1):10-8.
doi: 10.7326/0003-4819-158-1-201301010-00004.

HIV acquisition among women from selected areas of the United States: a cohort study

Sally L Hodder  1 , Jessica Justman, James P Hughes, Jing Wang, Danielle F Haley, Adaora A Adimora, Carlos Del Rio, Carol E Golin, Irene Kuo, Anne Rompalo, Lydia Soto-Torres, Sharon B Mannheimer, Letanya Johnson-Lewis, Susan H Eshleman, Wafaa M El-Sadr; HIV Prevention Trials Network 064; Women's HIV SeroIncidence Study Team
Affiliations

HIV acquisition among women from selected areas of the United States: a cohort study

Sally L Hodder et al. Ann Intern Med. .

Abstract

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.

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Conflict of interest statement

Potential Conflicts of Interest: Disclosures can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M12-1057.

Figures

Figure
Figure
Study flow diagram 1953 attended the visit and 27 missed the visit but returned at 12 mo. A total of 406 women completed the study at the 6-mo visit.
See this image and copyright information in PMC

References

    1. El-Sadr WM, Mayer KH, Hodder SL. AIDS in America—forgotten but not gone. N Engl J Med. 2010;362:967–970. [PMID: 20147707] - PMC - PubMed
    1. Centers for Disease Control and Prevention. HIV Among Women. 2011 Aug; Accessed at www.cdc.gov/hiv/topics/women/pdf/women.pdf on 6 September 2012.
    1. Centers for Disease Control and Prevention. HIV Surveillance in Women. [updated 6 April 2012]; Accessed at www.cdc.gov/hiv/topics/surveillance/resources/slides/women/index.htm on 6 September 2012.
    1. Hodder SL, Justman J, Haley DF, Adimora AA, Fogel CI, Golin CE HIV Prevention Trials Network Domestic Prevention in Women Working Group. Challenges of a hidden epidemic: HIV prevention among women in the United States. J Acquir Immune Defic Syndr. 2010;55(Suppl 2):S69–S73. - PMC - PubMed
    1. HIV Prevention Trials Network. Accessed at www.hptn.org/index.htm on 6 September 2012.

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