Chen Xinguang, Elliott Amy L, Wang Shuang
College of Public Health and Health Professions and College of Medicine, University of Florida, Gainesville, Florida USA.
Glob Health Res Policy. 2018 Feb 9;3:6. doi: 10.1186/s41256-018-0061-3. eCollection 2018.
Human behaviors are affected by attitudes and beliefs, which in turn are shaped by higher-level values to which we have ascribed. In this study, we explore the relationship between two higher-level values, press freedom and LGBT freedom, and HIV infection with national data at the population level.
Data were the number of persons living with HIV (PLWH, = 35,468,911) for 148 countries during 2011-15, press freedom index (PFI) determined by the Reporters Without Borders, and LGBT freedom index (LGBT-FI) based on laws regulating same-sex relationships and expression. PLWH prevalence (1/1000), PFI and LGBT-FI were mapped first. Multiple regression was thus used to associate the logarithm of PLWH prevalence with PFI, LGBT-FI and PFI × LGBT-FI interaction, controlling for per capita GDP and weighted by population size.
Global prevalence of PLWH during 2011-15 was 0.51 per 1000 population. The prevalence showed a geographic pattern moving from high at the south and west ends of the world map to low at the north and east. Both PFI and LGBT-FI were positively associated with PLWH prevalence with a negative interaction between the two.
More people are infected with HIV in countries with higher press freedom and higher LGBT freedom. Furthermore, press freedom can attenuate the positive association between levels of LGBT freedom and risk of HIV infection. This study demonstrated the urgency for and provided data supporting further research to investigate potential cultural and socioecological mechanisms underpinning the complex relationship among press freedom, LGBT freedom and HIV infection, with data collected at the individual level.
人类行为受态度和信念影响，而态度和信念又由我们所秉持的更高层次价值观塑造。在本研究中，我们利用国家层面的人口数据，探讨新闻自由和 LGBT 自由这两种更高层次价值观与艾滋病毒感染之间的关系。
数据包括 2011 - 2015 年期间 148 个国家的艾滋病毒感染者人数（PLWH，= 35,468,911）、无国界记者组织确定的新闻自由指数（PFI）以及基于同性关系和表达相关法律的 LGBT 自由指数（LGBT - FI）。首先绘制了 PLWH 患病率（每千分之一）、PFI 和 LGBT - FI 的地图。然后使用多元回归将 PLWH 患病率的对数与 PFI、LGBT - FI 以及 PFI×LGBT - FI 相互作用进行关联，控制人均国内生产总值并按人口规模加权。
2011 - 2015 年期间全球 PLWH 患病率为每千人口 0.51。患病率呈现出一种地理模式，从世界地图南端和西端的高值向北部和东部的低值移动。PFI 和 LGBT - FI 均与 PLWH 患病率呈正相关，且二者之间存在负向相互作用。
在新闻自由程度较高和 LGBT 自由程度较高的国家，感染艾滋病毒的人数更多。此外，新闻自由可减弱 LGBT 自由水平与艾滋病毒感染风险之间的正相关关系。本研究证明了开展进一步研究的紧迫性，并提供了数据支持，以便在个体层面收集数据，调查新闻自由、LGBT 自由和艾滋病毒感染之间复杂关系背后潜在的文化和社会生态机制。
