Wenzel Suzanne L, Rhoades Harmony, Tucker Joan S, Golinelli Daniela, Kennedy David P, Zhou Annie, Ewing Brett
University of Southern California, School of Social Work, 669 W. 34th Street, Los Angeles, CA 90089-0411, USA.
AIDS Educ Prev. 2012 Jun;24(3):270-9. doi: 10.1521/aeap.2012.24.3.270.
HIV is a serious epidemic among homeless persons, where rates of infection are estimated to be three times higher than in the general population. HIV testing is an effective tool for reducing HIV transmission and for combating poor HIV/AIDS health outcomes that disproportionately affect homeless persons, however, little is known about the HIV testing behavior of homeless men. This study examined the association between individual (HIV risk) and structural (service access) factors and past year HIV testing. Participants were a representative sample of 305 heterosexually active homeless men interviewed from meal programs in the Skid Row region of Los Angeles. Logistic regression examined the association between past year HIV testing and demographic characteristics, HIV risk behavior, and access to other services in the Skid Row area in the past 30 days. Despite high rates of past year HIV testing, study participants also reported high rates of HIV risk behavior, suggesting there is still significant unmet need for HIV prevention among homeless men. Having recently used medical/dental services in the Skid Row area (OR: 1.91; CI: 1.09, 3.35), and being a military veteran (OR: 2.10; CI: 1.01-4.37) were significantly associated with HIV testing service utilization. HIV testing was not associated with HIV risk behavior, but rather with access to services and veteran status, the latter of which prior research has linked to increased service access. We suggest that programs encouraging general medical service access may be important for disseminating HIV testing services to this high-risk, vulnerable population.
艾滋病毒在无家可归者中是一种严重的流行病，据估计，其感染率比普通人群高三倍。艾滋病毒检测是减少艾滋病毒传播以及对抗对无家可归者影响尤为严重的不良艾滋病毒/艾滋病健康结果的有效工具，然而，对于无家可归男性的艾滋病毒检测行为却知之甚少。本研究调查了个体（艾滋病毒风险）和结构（服务可及性）因素与过去一年艾滋病毒检测之间的关联。参与者是从洛杉矶贫民窟地区就餐项目中采访的305名有异性性行为的无家可归男性的代表性样本。逻辑回归分析了过去一年艾滋病毒检测与人口统计学特征、艾滋病毒风险行为以及过去30天内在贫民窟地区获得其他服务之间的关联。尽管过去一年艾滋病毒检测率很高，但研究参与者也报告了很高的艾滋病毒风险行为发生率，这表明无家可归男性对艾滋病毒预防仍有大量未满足的需求。最近在贫民窟地区使用过医疗/牙科服务（比值比：1.91；可信区间：1.09，3.35）以及曾是退伍军人（比值比：2.10；可信区间：1.01 - 4.37）与艾滋病毒检测服务的利用显著相关。艾滋病毒检测与艾滋病毒风险行为无关，而是与服务可及性和退伍军人身份有关，先前的研究已将后者与更多的服务可及性联系起来。我们建议，鼓励获得一般医疗服务的项目对于向这一高风险、易受伤害人群推广艾滋病毒检测服务可能很重要。
