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We estimated RAI prevalence (past\u2010year RAI) and RAI fraction (fraction of all sex acts (RVI and RAI) at the last sexual episode that were RAI among those reporting past\u2010year RAI) overall and by key demographic characteristics. These results and HIV incidence were used to calibrate a risk equation model to estimate the population attributable fraction of new HIV infections due to RAI (PAF\n                      <jats:sub>RAI<\/jats:sub>\n                      ) accounting for uncertainty in parameter assumptions.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Receptive anal intercourse prevalence (overall: 32%, city range: 19%\u201060%) and RAI fraction (overall: 27%, city range: 18%\u201034%) were high overall and across cities, and positively associated with exchange sex. RAI accounted for an estimated 41% (uncertainty range: 18%\u201055%) of new infections overall (city range: 21%\u201057%). Variability in PAF\n                      <jats:sub>RAI<\/jats:sub>\n                      estimates was most influenced by uncertainty in the estimate of the per\u2010act increased risk of RAI relative to RVI and the number of sex acts.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Receptive anal intercourse may contribute disproportionately to new heterosexually acquired HIV infections among at\u2010risk low\u2010income women in the USA, meaning that tools to prevent HIV transmission during RAI are warranted. The number of RVI and RAI acts should also be collected to monitor heterosexually acquired HIV infections.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/aji.13263","type":"journal-article","created":{"date-parts":[[2020,5,8]],"date-time":"2020-05-08T15:50:33Z","timestamp":1588953033000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":20,"title":["Receptive anal sex contributes substantially to heterosexually acquired HIV infections among at\u2010risk women in twenty US cities: Results from a modelling analysis"],"prefix":"10.1111","volume":"84","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2097-5465","authenticated-orcid":false,"given":"Jocelyn","family":"Elmes","sequence":"first","affiliation":[{"name":"Department of Infectious Disease Epidemiology Imperial College London London UK"},{"name":"Department of Public Health, Environments and Society London School of Hygiene and Tropical Medicine London 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