Urban-Rural Differences in HIV Testing Uptake Among US Women Survivors of Traumatic Childhood Sexual Abuse: A Cross-Sectional Population-Based Study Using 2022 BRFSS Data.

Abstract

PurposeTo assess the differences in Human Immunodeficiency Virus (HIV) testing among women survivors of traumatic Childhood Sexual Abuse (CSA) by urban-rural residency status.DesignCross-sectional survey.Setting2022 Behavioral Risk Factor Surveillance System (BRFSS).SampleAdult women (N = 6616) with a history of CSA from 12 US states.MeasureOutcome was HIV testing. Covariates included sociodemographic characteristics, health-risk behaviors, perceived health status, presence of any disability, and subjective cognitive decline.AnalysisWe conducted three multivariable logistic regression models for urban-only, rural-only, and both, summarizing associations between HIV testing and covariates using adjusted odds ratios (aORs) and survey-weighted estimates.ResultsLogistic regression analysis highlighted significant urban-rural differences in HIV testing among Women CSA (WCSA) survivors. Among urban women, those aged 45-55 (aOR = 4.96), Asians (aOR = 9.58), current smokers (aOR = 2.13), and those with subjective cognitive decline (aOR = 2.99) had higher odds of HIV testing compared to their counterparts. Among rural women, being Hispanic (aOR = 19.40) and a current smoker (aOR = 3.44) were associated with higher odds of HIV testing. All P-values < .05.ConclusionsFindings highlight the need for future research on interventions including raising awareness on different testing strategies for rural WCSA survivors with lesser education to enhance HIV testing uptake.