摘要：Objectives . We investigated history of abuse and other HIV-related risk factors in a community sample of 490 HIV-positive and HIV-negative African American, European American, and Latina women. Methods . Baseline interviews were analyzed, and logistic regressions were used to identify predictors of risk for positive HIV serostatus overall and by racial/ethnic group. Results . Race/ethnicity was not an independent predictor of HIV-related risk, and few racial/ethnic differences in risk factors for HIV were seen. Regardless of race/ethnicity, HIV-positive women had more sexual partners, more sexually transmitted diseases, and more severe histories of abuse than did HIV-negative women. Trauma history was a general risk factor for women, irrespective of race/ethnicity. Conclusions . Limited material resources, exposure to violence, and high-risk sexual behaviors were the best predictors of HIV risk. America is facing a public health crisis. HIV infection and AIDS among women in the United States have increased dramatically over the last decade. 1 Although only 1 in 4 women in the United States is African American or Latina, these women represent 77% of the AIDS cases. 1 These national rates are replicated in Los Angeles, Calif, where the HIV and AIDS incidence rate among African American women (21 per 100 000) was 10 times higher than the rate among European American women (2 per 100 000) and 3 times higher than the rate among Latina women (7 per 100 000). 2 Several factors account for disproportionate HIV morbidity, including racial/ethnic group affiliation, socioeconomic status, overall health, sexual risk taking, and higher rates of sexually transmitted diseases (STDs). 3– 5 Women who report early and chronic sexual abuse have a 7-fold increase in HIV-related risk behaviors and markers of risk compared with women with us abuse histories. 6– 11 Furthermore, 1 in 3 women report sexual abuse before age 18 years, and 4 million women become domestic violence victims annually. 12 However, when income is controlled, race/ethnicity does not appear to be a specific risk factor for violence. 13– 15 Therefore, additional research is needed to better understand how histories of sexual and physical trauma may contribute to greater risks for HIV and AIDS in women, particularly women of color.
