Wiewel Ellen W, Bocour Angelica, Kersanske Laura S, Bodach Sara D, Xia Qiang, Braunstein Sarah L
New York City Department of Health and Mental Hygiene, HIV Epidemiology and Field Services Program, Long Island City, NY; Current affiliation: New York City Department of Health and Mental Hygiene, Division of Disease Control, Long Island City, NY.
New York City Department of Health and Mental Hygiene, HIV Epidemiology and Field Services Program, Long Island City, NY.
Public Health Rep. 2016 Mar-Apr;131(2):290-302. doi: 10.1177/003335491613100213.
We assessed the association of neighborhood poverty with HIV diagnosis rates for males and females in New York City.
We calculated annual HIV diagnosis rates by ZIP Code, sex, and neighborhood poverty level using 2010-2011 New York City (NYC) HIV surveillance data and data from the U.S. Census 2010 and American Community Survey 2007-2011. Neighborhood poverty levels were percentage of residents in a ZIP Code with incomes below the federal poverty threshold, categorized as 0%-<10% (low poverty), 10%-<20% (medium poverty), 20%-<30% (high poverty), and 30%-100% (very high poverty). We used sex-stratified negative binomial regression models to measure the association between neighborhood-level poverty and HIV diagnosis rates, controlling for neighborhood-level education, race/ethnicity, age, and percentage of men who have sex with men.
In 2010-2011, 6,184 people were newly diagnosed with HIV. Median diagnosis rates per 100,000 population increased by neighborhood poverty level overall (13.7, 34.3, 50.6, and 75.6 for low-, medium-, high-, and very high-poverty ZIP Codes, respectively), for males, and for females. In regression models, higher neighborhood poverty remained associated with higher diagnosis rates among males (adjusted rate ratio [ARR] = 1.63, 95% confidence interval [CI] 1.34, 1.97) and females (ARR=2.14, 95% CI 1.46, 3.14) for very high- vs. low-poverty ZIP Codes.
Living in very high- vs. low-poverty urban neighborhoods was associated with increased HIV diagnosis rates. After controlling for other factors, the association between poverty and diagnosis rates was stronger among females than among males. Alleviating poverty may help decrease HIV-related disparities.
我们评估了纽约市社区贫困与男性和女性艾滋病毒诊断率之间的关联。
我们使用2010 - 2011年纽约市（NYC）艾滋病毒监测数据以及2010年美国人口普查和2007 - 2011年美国社区调查的数据，按邮政编码、性别和社区贫困水平计算年度艾滋病毒诊断率。社区贫困水平是指邮政编码区域内收入低于联邦贫困线的居民百分比，分为0% - <10%（低贫困）、10% - <20%（中等贫困）、20% - <30%（高贫困）和30% - 100%（非常高贫困）。我们使用按性别分层的负二项回归模型来衡量社区层面贫困与艾滋病毒诊断率之间的关联，并控制社区层面的教育程度、种族/族裔、年龄以及男男性行为者的百分比。
在2010 - 2011年，有6184人新诊断出感染艾滋病毒。总体上，每10万人口的诊断率中位数随社区贫困水平上升（低、中、高和非常高贫困邮政编码区域分别为13.7、34.3、50.6和75.6），男性和女性均如此。在回归模型中，与低贫困邮政编码区域相比，非常高贫困邮政编码区域的社区贫困程度越高，男性（调整率比[ARR] = 1.63，95%置信区间[CI] 1.34，1.97）和女性（ARR = 2.14，95% CI 1.46，3.14）的诊断率越高。
生活在非常高贫困与低贫困的城市社区与艾滋病毒诊断率上升有关。在控制其他因素后，贫困与诊断率之间的关联在女性中比在男性中更强。减轻贫困可能有助于减少与艾滋病毒相关的差异。
