美国男男性行为者和异性恋女性中的艾滋病毒：一项生态学分析。

HIV Among MSM and Heterosexual Women in the United States: An Ecologic Analysis.

作者信息

Raymond H Fisher, Al-Tayyib Alia, Neaigus Alan, Reilly Kathleen H, Braunstein Sarah, Brady Kathleen A, Sey Ekow, Risser Jan, Padget Paige, Lalota Marlene, Schacht John-Mark, Forrest David W, Macomber Katie, Griffin Vivian, Higgins Emily, Robinson William T, Zarwell Meagan C, Opoku Jenevieve, Magnus Manya, Kuo Irene, Burt Richard, Thiede Hanne, Glick Sara, Flynn Colin, German Danielle

机构信息

*San Francisco Department of Public Health, San Francisco, CA; †Denver Public Health, Denver, CO; ‡New York City Department of Health & Mental Hygiene, Queens, NY; §Philadelphia Department of Public Health, Philadelphia, PA; ‖Los Angeles County Department of Public Health, Los Angeles, CA; ¶UTHealth, The University of Texas Health Science Center at Houston, School of Public Health, Houston, TX; #Florida Department of Health, Tallahassee, FL; **University of Miami, Miami, Florida; ††Michigan Department of Health and Human Services; ‡‡Louisiana State University Health Sciences Center in New Orleans, Louisiana Department of Health, Office of Public Health, Lansing Michigan, New Orleans, LA; §§Louisiana State University Health Sciences Center, New Orleans, LA; ‖‖District of Columbia Department of Health; ¶¶George Washington University, District of Columbia; ##Public Health Seattle-King County, Seattle, WA; ***Maryland Department of Public Health; and †††Johns Hopkins Bloomberg School of Public Health, Baltimore, MD.

出版信息

J Acquir Immune Defic Syndr. 2017 Jul 1;75 Suppl 3:S276-S280. doi: 10.1097/QAI.0000000000001422.

DOI:10.1097/QAI.0000000000001422

PMID:28604428

Abstract

BACKGROUND

Phylogenetic studies show links between heterosexual women and men who have sex with men (MSM) that are more numerous than from heterosexual men to women suggesting that HIV infections among heterosexual women may stem from MSM. Poor communities have been associated with high rates of HIV among heterosexual women. Our analysis investigates potential transmission of HIV between MSM and female heterosexuals.

METHODS

National HIV Behavioral Surveillance data describe transmission risk behaviors of MSM, and HIV case reporting data describe the percentages of cases that are attributed to transmission risk categories. We examined correlations between the percentages of men who were MSM who also have sex with women and female heterosexual cases. We also examined census data to characterize each city in terms of poverty level and race/ethnicity makeup.

RESULTS

There was a high correlation (0.93) between the percentage of reported living HIV cases attributed to male heterosexual contact and female heterosexual contact and a moderate nonsignificant correlation (0.49) between the percentage of MSM who were men who have sex with men and women (MSMW) in National HIV Behavioral Surveillance and the percentage of reported cases that were attributed to female heterosexual contact suggesting some potential overlap. Cities with high levels of poverty and African American/Black residents had higher levels of MSMW and higher levels of heterosexual female cases.

CONCLUSIONS

Addressing HIV in cities with high levels of MSMW may have the dual effect of improving the health of MSM populations that have a high burden of HIV and to improve the health of their larger communities.

摘要

背景

系统发育研究表明，异性恋女性与男男性行为者（MSM）之间的联系比异性恋男性与女性之间的联系更多，这表明异性恋女性中的艾滋病毒感染可能源于男男性行为者。贫困社区与异性恋女性中高艾滋病毒感染率有关。我们的分析调查了男男性行为者与异性恋女性之间艾滋病毒的潜在传播情况。

方法

全国艾滋病毒行为监测数据描述了男男性行为者的传播风险行为，艾滋病毒病例报告数据描述了归因于传播风险类别的病例百分比。我们研究了同时与女性发生性行为的男男性行为者的百分比与异性恋女性病例之间的相关性。我们还研究了人口普查数据，以根据贫困水平和种族/族裔构成来描述每个城市的特征。

结果

报告的存活艾滋病毒病例中归因于男性异性接触和女性异性接触的百分比之间存在高度相关性（0.93），全国艾滋病毒行为监测中与男性和女性都发生性行为的男男性行为者（MSMW）的百分比与报告病例中归因于女性异性接触的百分比之间存在中等程度的非显著相关性（0.49），这表明存在一些潜在的重叠。贫困程度高且非裔美国人/黑人居民多的城市，MSMW水平较高，异性恋女性病例水平也较高。