Vaughan Adam S, Kramer Michael R, Cooper Hannah L F, Rosenberg Eli S, Sullivan Patrick S
Department of Epidemiology, Rollins School of Public Health, 1518 Clifton Rd NE, Emory University, Atlanta, GA 30322, USA; Laney Graduate School, Emory University, 201 Dowman Drive, Atlanta, GA 30322, USA.
Laney Graduate School, Emory University, 201 Dowman Drive, Atlanta, GA 30322, USA; Department of Behavioral Sciences and Health Education, Rollins School of Public Health, 1518 Clifton Rd NE, Emory University, Atlanta, GA 30322, USA.
Soc Sci Med. 2017 Feb;175:1-10. doi: 10.1016/j.socscimed.2016.12.034. Epub 2016 Dec 24.
Theory and research on HIV and among men who have sex with men (MSM) have long suggested the importance of non-residential locations in defining structural exposures. Despite this, most studies within these fields define place as a residential context, neglecting the potential influence of non-residential locations on HIV-related outcomes. The concept of activity spaces, defined as a set of locations to which an individual is routinely exposed, represents one theoretical basis for addressing this potential imbalance. Using a one-time online survey to collect demographic, behavioral, and spatial data from MSM, this paper describes activity spaces and examines correlates of this spatial variation. We used latent class analysis to identify categories of activity spaces using spatial data on home, routine, potential sexual risk, and HIV prevention locations. We then assessed individual and area-level covariates for their associations with these categories. Classes were distinguished by the degree of spatial variation in routine and prevention behaviors (which were the same within each class) and in sexual risk behaviors (i.e., sex locations and locations of meeting sex partners). Partner type (e.g. casual or main) represented a key correlate of the activity space. In this early examination of activity spaces in an online sample of MSM, patterns of spatial behavior represent further evidence of significant spatial variation in locations of routine, potential HIV sexual risk, and HIV prevention behaviors among MSM. Although prevention behaviors tend to have similar geographic variation as routine behaviors, locations where men engage in potentially high-risk behaviors may be more spatially focused for some MSM than for others.
关于艾滋病毒以及男男性行为者(MSM)的理论和研究长期以来一直表明非居住场所对于界定结构性暴露的重要性。尽管如此,这些领域中的大多数研究将场所定义为居住环境,而忽略了非居住场所在艾滋病毒相关结果方面的潜在影响。活动空间的概念,被定义为个体日常接触的一组场所,是解决这种潜在失衡问题的一个理论基础。本文通过一次在线调查收集男男性行为者的人口统计学、行为学和空间数据,描述了活动空间并研究了这种空间差异的相关因素。我们使用潜在类别分析,利用关于家庭、日常活动、潜在性风险和艾滋病毒预防场所的空间数据来确定活动空间的类别。然后,我们评估了个体和区域层面的协变量与这些类别的关联。不同类别通过日常活动和预防行为(在每个类别中是相同的)以及性风险行为(即性行为场所和结识性伴侣的场所)的空间差异程度来区分。伴侣类型(例如临时或主要伴侣)是活动空间的一个关键相关因素。在对男男性行为者在线样本中的活动空间进行的这项早期研究中,空间行为模式进一步证明了男男性行为者在日常活动、潜在艾滋病毒性风险和艾滋病毒预防行为场所方面存在显著的空间差异。尽管预防行为往往与日常行为具有相似的地理差异,但对于一些男男性行为者来说,他们进行潜在高风险行为的场所可能比其他男男性行为者在空间上更为集中。