纽约市男男性行为者中基于地点的HIV病毒抑制和持续抑制预测因素
Place-Based Predictors of HIV Viral Suppression and Durable Suppression Among Men Who Have Sex With Men in New York City.
作者信息
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
机构信息
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.
出版信息
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。
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