Jefferson Kevin A, Kersanske Laura S, Wolfe Mary E, Braunstein Sarah L, Haardörfer Regine, Jarlais Don C Des, Campbell Aimee N C, Cooper Hannah L F
Rollins School of Public Health at Emory University, 1518 Clifton Road NE, Atlanta, GA, 30322, USA.
New York City Department of Health and Mental Hygiene, 42-09 28th Street, Queens, NY, 11101, USA.
AIDS Behav. 2017 Oct;21(10):2987-2999. doi: 10.1007/s10461-017-1810-x.
We explore relationships between place characteristics and HIV viral suppression among HIV-positive men who have sex with men (MSM) in New York City (NYC). We conducted multilevel analyses to examine associations of United Hospital Fund (UHF)-level characteristics to individual-level suppression and durable suppression among MSM. Individual-level independent and dependent variables came from MSM in NYC's HIV surveillance registry who had been diagnosed in 2009-2013 (N = 7159). UHF-level covariates captured demographic composition, economic disadvantage, healthcare access, social disorder, and police stop and frisk rates. 56.89% of MSM achieved suppression; 35.49% achieved durable suppression. MSM in UHFs where 5-29% of residents were Black had a greater likelihood of suppression (reference: ≥30% Black; adjusted relative risk (ARR) = 1.07, p = 0.04). MSM in UHFs with <30 MSM-headed households/10,000 households had a lower likelihood of achieving durable suppression (reference: ≥60 MSM-headed households/10,000; ARR = 0.82; p = 0.05). Place characteristics may influence viral suppression. Longitudinal research should confirm these associations.
我们探讨了纽约市男男性行为者（MSM）中，地点特征与HIV病毒抑制之间的关系。我们进行了多层次分析，以检验联合医院基金（UHF）层面的特征与MSM个体层面的病毒抑制及持续病毒抑制之间的关联。个体层面的自变量和因变量来自纽约市HIV监测登记处中2009 - 2013年被诊断出感染HIV的MSM（N = 7159）。UHF层面的协变量涵盖了人口构成、经济劣势、医疗保健可及性、社会失序以及警方拦截和搜身率。56.89%的MSM实现了病毒抑制；35.49%实现了持续病毒抑制。在居民中5 - 29%为黑人的UHF中的MSM实现病毒抑制的可能性更大（参照：黑人比例≥30%；调整后相对风险（ARR）= 1.07，p = 0.04）。在每10000户家庭中男户主家庭少于30户的UHF中的MSM实现持续病毒抑制的可能性较低（参照：每10000户家庭中男户主家庭≥60户；ARR = 0.82；p = 0.05）。地点特征可能会影响病毒抑制。纵向研究应证实这些关联。
