BackgroundSouth African women have the highest burden of HIV infections globally. We investigated the temporal trends and the impact of key factors associated with HIV diagnosis among a nationally representative cohort of South African women.MethodsTotal of 24,657 women who participated in the National HIV, Behaviour and Health Surveys conducted from 2002-to-2017.ResultsDespite decades-long prevention efforts, we observed a significant increase in HIV prevalence over time (22% in 2002 to 21% in 2005-2008 and 29% in 2012-2017). Overall, 46% of the women living with HIV were not aware of their risk of HIV with age-specific disparities. Our findings revealed compelling evidence between HIV seropositivity and high HIV risk-perception (adjusted Odds Ratio (aOR):1.47 to 3.29) which increased overtime and exceeded the other factors. At a population-level, 45% of the HIV diagnoses were exclusively associated with women who believed they were at risk of HIV in 2012-2017. Women who reported using condoms at last sexual act were also at increased risk of HIV infection, with a population attributable risk of 18% (2002) to 21% (2012-2017).ConclusionThere is an urgent need for culturally, socially, and linguistically appropriate prevention and awareness campaigns with realistic, non-confrontational messages.

中文翻译：

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了解女性正确的风险认知对人类免疫缺陷病毒诊断的影响：来自南非的见解

背景南非妇女的艾滋病毒感染负担是全球最高的。我们调查了具有全国代表性的南非女性群体中与艾滋病毒诊断相关的关键因素的时间趋势和影响。方法共有 24,657 名女性参加了 2002 年至 2017 年进行的国家艾滋病毒、行为和健康调查。结果尽管经过了几十年经过长期的预防工作，我们观察到艾滋病毒感染率随着时间的推移显着增加（2002 年为 22%，2005-2008 年为 21%，2012-2017 年为 29%）。总体而言，46% 的艾滋病毒感染女性不知道自己感染艾滋病毒的风险存在年龄差异。我们的研究结果揭示了 HIV 血清阳性和高 HIV 风险感知之间的令人信服的证据（调整后的优势比 (aOR)：1.47 至 3.29），这增加了加班时间并超过了其他因素。在人口层面，2012-2017 年，45% 的艾滋病毒诊断仅与认为自己有感染艾滋病毒风险的女性有关。自称在最后一次性行为中使用安全套的女性感染艾滋病毒的风险也增加，人群归因风险为 18%（2002 年）至 21%（2012-2017 年）。结论迫切需要在文化、社会和语言方面采取措施适当的预防和宣传活动，传达现实的、非对抗性的信息。