Vaughan Adam S, Kramer Michael R, Cooper Hannah Lf, Rosenberg Eli S, Sullivan Patrick S
Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, United States.
J Med Internet Res. 2016 Jun 9;18(6):e142. doi: 10.2196/jmir.5701.
Place is critical to our understanding of human immunodeficiency virus (HIV) infections among men who have sex with men (MSM) in the United States. However, within the scientific literature, place is almost always represented by residential location, suggesting a fundamental assumption of equivalency between neighborhood of residence, place of risk, and place of prevention. However, the locations of behaviors among MSM show significant spatial variation, and theory has posited the importance of nonresidential contextual exposures. This focus on residential locations has been at least partially necessitated by the difficulties in collecting detailed geolocated data required to explore nonresidential locations.
Using a Web-based map tool to collect locations, which may be relevant to the daily lives and health behaviors of MSM, this study examines the completeness and reliability of the collected data.
MSM were recruited on the Web and completed a Web-based survey. Within this survey, men used a map tool embedded within a question to indicate their homes and multiple nonresidential locations, including those representing work, sex, socialization, physician, and others. We assessed data quality by examining data completeness and reliability. We used logistic regression to identify demographic, contextual, and location-specific predictors of answering all eligible map questions and answering specific map questions. We assessed data reliability by comparing selected locations with other participant-reported data.
Of 247 men completing the survey, 167 (67.6%) answered the entire set of eligible map questions. Most participants (>80%) answered specific map questions, with sex locations being the least reported (80.6%). Participants with no college education were less likely than those with a college education to answer all map questions (prevalence ratio, 0.4; 95% CI, 0.2-0.8). Participants who reported sex at their partner's home were less likely to indicate the location of that sex (prevalence ratio, 0.8; 95% CI, 0.7-1.0). Overall, 83% of participants placed their home's location within the boundaries of their reported residential ZIP code. Of locations having a specific text description, the median distance between the participant-selected location and the location determined using the specific text description was 0.29 miles (25th and 75th percentiles, 0.06-0.88).
Using this Web-based map tool, this Web-based sample of MSM was generally willing and able to provide accurate data regarding both home and nonresidential locations. This tool provides a mechanism to collect data that can be used in more nuanced studies of place and sexual risk and preventive behaviors of MSM.
场所对于我们理解美国男男性行为者(MSM)中的人类免疫缺陷病毒(HIV)感染情况至关重要。然而,在科学文献中,场所几乎总是由居住地点来表示,这意味着在居住社区、风险场所和预防场所之间存在一种基本的等效性假设。然而,MSM行为发生的地点存在显著的空间差异,并且理论已经假定了非居住环境暴露的重要性。对居住地点的这种关注至少部分是由于收集探索非居住地点所需的详细地理位置数据存在困难。
本研究使用基于网络的地图工具收集可能与MSM日常生活和健康行为相关的地点信息,以检验所收集数据的完整性和可靠性。
通过网络招募MSM并让他们完成一项基于网络的调查。在这项调查中,男性使用嵌入在一个问题中的地图工具来标明他们的家以及多个非居住地点,包括那些代表工作、性行为、社交、就医等的地点。我们通过检查数据完整性和可靠性来评估数据质量。我们使用逻辑回归来确定回答所有合格地图问题以及回答特定地图问题的人口统计学、环境和特定地点预测因素。我们通过将选定地点与其他参与者报告的数据进行比较来评估数据可靠性。
在完成调查的247名男性中,167名(67.6%)回答了整套合格的地图问题。大多数参与者(>80%)回答了特定地图问题,其中性行为地点报告得最少(80.6%)。未受过大学教育的参与者比受过大学教育的参与者回答所有地图问题的可能性更小(患病率比,0.4;95%置信区间,0.2 - 0.8)。报告在伴侣家中发生性行为的参与者指明该性行为地点的可能性更小(患病率比,0.8;95%置信区间,0.7 - 1.0)。总体而言,83%的参与者将他们家的位置标注在其报告的居住邮政编码区域范围内。对于有特定文本描述的地点,参与者选择的地点与使用特定文本描述确定的地点之间的中位距离为0.29英里(第25和第75百分位数,0.06 - 0.88)。
使用这种基于网络的地图工具,这个基于网络的MSM样本总体上愿意并且能够提供关于家庭和非居住地点的准确数据。这个工具提供了一种收集数据的机制,可用于对MSM的场所、性风险及预防行为进行更细致入微的研究。