Sweeney Patricia, Gray Simone C, Purcell David W, Sewell Jenny, Babu Aruna Surendera, Tarver Brett A, Prejean Joseph, Mermin Jonathan
aDivision of HIV/AIDS Prevention bICF Macro International cNational Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.
AIDS. 2017 Jun 19;31(10):1483-1488. doi: 10.1097/QAD.0000000000001501.
To assess whether state criminal exposure laws are associated with HIV and stage 3 (AIDS) diagnosis rates in the United States.
We assessed the relationship between HIV and stage 3 (AIDS) diagnosis data from the National HIV Surveillance System and the presence of a state criminal exposure law as identified through WestlawNext by using generalized estimating equations.
We limited analysis to persons aged at least 13 years with diagnosed HIV infection or AIDS reported to the National HIV Surveillance System of the Centers for Disease Control and Prevention. The primary outcome measures were rates of diagnosis of HIV (2001-2010 in 33 states) and AIDS (1994-2010 in 50 states) per 100 000 individuals per year. In addition to criminal exposure laws, state-level factors evaluated for inclusion in models included income, unemployment, poverty, education, urbanicity, and race/ethnicity.
At the end of the study period, 30 states had laws criminalizing HIV exposure. In bivariate models (P < 0.05), unemployment, poverty, education, urbanicity, and race/ethnicity were associated with HIV and AIDS diagnoses. In final models, proportion of adults with less than a high school education and percentage of the population living in urban areas were significantly associated with HIV and AIDS diagnoses over time; criminal exposure laws were not associated with diagnosis rates.
We found no association between HIV or AIDS diagnosis rates and criminal exposure laws across states over time, suggesting that these laws have had no detectable HIV prevention effect.
评估美国各州的刑事暴露法律是否与艾滋病毒及3期（艾滋病）诊断率相关。
我们使用广义估计方程评估了来自国家艾滋病毒监测系统的艾滋病毒及3期（艾滋病）诊断数据与通过WestlawNext确定的州刑事暴露法律之间的关系。
我们将分析限制在向疾病控制与预防中心的国家艾滋病毒监测系统报告了确诊艾滋病毒感染或艾滋病的13岁及以上人群。主要结局指标是每年每10万人中的艾滋病毒诊断率（33个州为2001 - 2010年）和艾滋病诊断率（50个州为1994 - 2010年）。除了刑事暴露法律外，评估纳入模型的州级因素包括收入、失业率、贫困率、教育程度、城市化程度和种族/族裔。
在研究期结束时，30个州有将艾滋病毒暴露定为犯罪的法律。在双变量模型中（P < 0.05），失业率、贫困率、教育程度、城市化程度和种族/族裔与艾滋病毒及艾滋病诊断相关。在最终模型中，未受过高中教育的成年人比例和城市地区人口百分比与艾滋病毒及艾滋病诊断随时间显著相关；刑事暴露法律与诊断率无关。
我们发现随着时间推移，各州的艾滋病毒或艾滋病诊断率与刑事暴露法律之间没有关联，这表明这些法律没有可检测到的艾滋病毒预防效果。
