Department of Epidemiology, Robert Stempel College of Public Health and Social Work, Florida International University, Miami, FL, USA.
Center for Research on US Latino HIV/AIDS and Drug Abuse, Florida International University, Miami, FL, USA.
AIDS Behav. 2018 Sep;22(9):2978-2993. doi: 10.1007/s10461-018-2032-6.
This study's objective was to examine the role of gay neighborhood residence and other neighborhood factors in racial/ethnic disparities in retention in HIV care and viral load suppression during 2015. Florida residents diagnosed 2000-2014 with HIV infection and with transmission mode of men who have sex with men (MSM) were included in multi-level logistic regression models. Of 29,156 MSM, 29.4% were not retained and 34.2% were not virally suppressed. Non-Hispanic Blacks (NHB) had a higher likelihood of not being retained (adjusted prevalence ratio [aPR] 1.31, 95% confidence interval [CI] 1.24-1.38, p value < 0.0001) and not being virally suppressed (aPR 1.82, 95% CI 1.67-1.98, p value < 0.0001) compared with non-Hispanic Whites. Among NHBs, rural residence was protective for both outcomes. Although gay neighborhood residence was not associated with either outcome, the role of other neighborhood factors suggests that individual and neighborhood barriers to HIV care and treatment should be addressed among MSM.
本研究旨在探讨 2015 年期间,同性恋聚居区居住情况和其他社区因素在保留艾滋病毒护理和病毒载量抑制方面的种族/民族差异中的作用。纳入了 2000-2014 年间被诊断患有艾滋病毒感染且传播模式为男男性行为者(MSM)的佛罗里达州居民,采用多层次逻辑回归模型进行分析。在 29156 名 MSM 中,有 29.4%的人未被保留,34.2%的人未被抑制病毒载量。非西班牙裔黑人(NHB)未被保留的可能性更高(调整后的患病率比 [aPR] 为 1.31,95%置信区间 [CI] 为 1.24-1.38,p 值 < 0.0001),且病毒载量未被抑制的可能性更高(aPR 为 1.82,95% CI 为 1.67-1.98,p 值 < 0.0001),与非西班牙裔白人相比。在 NHB 中,农村居住对这两种结果都有保护作用。尽管同性恋聚居区居住情况与这两种结果都没有关联,但其他社区因素的作用表明,应该解决 MSM 中艾滋病毒护理和治疗的个体和社区障碍。