title: HIV among women in the District of Columbia: an evolving epidemic?
abstract: The epidemiology of HIV in urban centers of the United States such as the District of Columbia (DC) is dynamic with rates of new HIV and AIDS diagnoses as well as risk factors elevated. Correlates of HIV among heterosexual women extend beyond traditional, individual risk factors to structural factors. The purpose of this study was to compare proportions of HIV and correlates of HIV among women participating in National HIV behavioral surveillance (NHBS) system in 2006-7 (NHBS Cycle 1) and 2010 (NHBS Cycle 2). Analysis of 677 female participants at elevated risk for HIV revealed high prevalence of individual-level HIV-associated risk factors (e.g., sexual behavior) and socio-structural associated risk factors (e.g., homelessness, incarceration, lack of health insurance). While a greater proportion of women were HIV-infected in Cycle 2, after controlling for the distribution of demographic characteristics to adjust for a change in eligibility criteria, the pooled sample did not reveal a significantly increased proportion of HIV-infected women in Cycle 2. Homelessness and condom use were associated with greater relative odds of HIV after adjustment for confounders, and non-injection drug use was associated with reduced odds. Findings inform our understanding of the continuing HIV epidemic in DC and support development of effective interventions to slow the epidemic among women in DC and similar urban centers.
authors.affiliation: Department of Epidemiology and Biostatistics, The George Washington University School of Public Health and Health Services, 2100-W Pennsylvania Avenue, Suite 807, Washington, DC, 20037, USA, manyadm@gwu.edu.
authors.forename: Manya
authors.initials: M
authors.lastname: Magnus
authors.forename: Gregory
authors.initials: G
authors.lastname: Phillips
authors.forename: Irene
authors.initials: I
authors.lastname: Kuo
authors.forename: James
authors.initials: J
authors.lastname: Peterson
authors.forename: Anthony
authors.initials: A
authors.lastname: Rawls
authors.forename: Tiffany
authors.initials: T
authors.lastname: West-Ojo
authors.forename: Yujiang
authors.initials: Y
authors.lastname: Jia
authors.forename: Jenevieve
authors.initials: J
authors.lastname: Opoku
authors.forename: Alan E
authors.initials: AE
authors.lastname: Greenberg
mesh_terms: D000293:Adolescent; D000328:Adult; D040343:Behavioral Risk Factor Surveillance System; D017280:Condoms / Q000706:statistics & numerical data; D004219:District of Columbia / Q000453:epidemiology; D058872:Epidemics; D005260:Female; D015658:HIV Infections / Q000453:epidemiology* / Q000517:prevention & control*; D006679:HIV Seropositivity / Q000453:epidemiology*; D020010:Heterosexuality; D006703:Ill-Housed Persons / Q000706:statistics & numerical data; D006801:Humans; D008875:Middle Aged; D015995:Prevalence; D012307:Risk Factors; D012309:Risk-Taking; D012959:Socioeconomic Factors; D047568:Unsafe Sex / Q000706:statistics & numerical data; D055815:Young Adult