1 Department of Community and Rural Medicine, Institute for Rural Health Research, College of Community Health Sciences, The University of Alabama , Tuscaloosa, Alabama.
2 Division of HIV/AIDS Prevention, Centers for Disease Control and Prevention , Atlanta, Georgia .
LGBT Health. 2017 Feb;4(1):34-41. doi: 10.1089/lgbt.2016.0126. Epub 2017 Jan 3.
Among young men who have sex with men (YMSM), aged 13-24 years, Blacks/African Americans and Hispanics/Latinos are disproportionately affected by HIV, accounting for 58% and 21%, respectively, of diagnoses of HIV infection in the United States. In the District of Columbia (DC), YMSM of color are also disproportionately affected by HIV. National goals are that 80% of HIV-infected persons be retained in HIV care. We analyzed DC surveillance data to examine retention among YMSM living with HIV infection in DC.
We characterized correlates of retention in HIV care (≥2 clinical visits, ≥3 months apart, within 12 months of diagnosis) among YMSM in DC to inform and strengthen local HIV care efforts. We analyzed data from DC HIV surveillance system for YMSM aged 13-29 years diagnosed between 2005 and 2012 and alive in 2013. We also combined demographic and clinical variables with sociodemographic data from the U.S. American Community Survey (ACS) by census tracts.
From 2005 to 2012, 1034 YMSM were diagnosed and living with HIV infection in DC; 83% were Black or Latino. Of the 1034 YMSM, 910 (88%) had census tract data available and were included in analyses (72% Black, 10% Latino, and 17% White); among the 854 (94%) linked to care, 376 (44%) were retained in care. In multivariate analyses, retention in care was less likely among 19-24 year YMSM compared with 13-18-year-old YMSM (adjusted prevalence ratios [aPR] = 0.89, 95% confidence intervals [CI] 0.80-0.99).
Retention in HIV care was suboptimal for YMSM. Increased retention efforts are warranted to improve outcomes and reduce age and racial/ethnic disparities.
在美国，13-24 岁的男男性行为者（MSM）中，黑人和非裔美国人以及西班牙裔或拉丁裔青年感染 HIV 的比例过高，分别占 HIV 感染诊断的 58%和 21%。在哥伦比亚特区（DC），有色人种的 MSM 也受到 HIV 的不成比例的影响。国家目标是使 80%的 HIV 感染者接受 HIV 护理。我们分析了 DC 监测数据，以研究 DC 感染 HIV 的 MSM 的保留情况。
我们描述了 DC 感染 HIV 的 MSM 保留在 HIV 护理中的相关因素（在诊断后 12 个月内，至少进行 2 次临床就诊，间隔至少 3 个月），为加强当地 HIV 护理工作提供信息。我们分析了 2005 年至 2012 年期间诊断并于 2013 年存活的年龄在 13-29 岁的 DC 艾滋病监测系统中的 MSM 的数据。我们还将人口统计和临床变量与美国社区调查（ACS）的社会经济数据（按普查区）进行了合并。
2005 年至 2012 年期间，1034 名 MSM 在 DC 被诊断为 HIV 感染者并存活；其中 83%是黑人或拉丁裔。在 1034 名 MSM 中，有 910 名（88%）有普查区数据，他们被纳入分析（72%是黑人，10%是拉丁裔，17%是白人）；在 854 名（94%）与护理机构有联系的 MSM 中，有 376 名（44%）保留在护理中。在多变量分析中，与 13-18 岁的 MSM 相比，19-24 岁的 MSM 保留在护理中的可能性较小（调整后的患病率比[aPR]为 0.89，95%置信区间[CI]为 0.80-0.99）。
HIV 护理的保留率对 MSM 来说并不理想。需要加强保留护理的努力，以改善结果并减少年龄和种族/族裔差异。
