Patrick S. Sullivan, Taylor A. Wimbly, and Eric Hall are with the Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA. David W. Purcell is with the Division of HIV/AIDS Prevention, National Center for HIV, Viral Hepatitis, STD and TB Prevention, Centers for Disease Control and Prevention, Atlanta. Jeremy A. Grey, Kyle T. Bernstein, and Thomas L. Gift are with the Division of STD Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD and TB Prevention, Centers for Disease Control and Prevention, Atlanta. Eli S. Rosenberg is with the Department of Epidemiology and Biostatistics, University at Albany School of Public Health, State University of New York, Albany.
Am J Public Health. 2018 Nov;108(S4):S266-S273. doi: 10.2105/AJPH.2018.304762.
To describe disparities in HIV infection and syphilis among gay, bisexual, and other men who have sex with men (MSM) in US states through ratio-based measures and graphical depictions of disparities.
We used state-level surveillance data of reported HIV and syphilis cases in 2015 and 2016, and estimates of MSM population sizes to estimate HIV and syphilis prevalence by race/ethnicity and rate ratios (RRs) and to visually display patterns of disparity and prevalence among US states.
State-specific rates of new HIV diagnoses were higher for Black than for White MSM (RR range = 2.35 [Rhode Island] to 10.12 [Wisconsin]) and for Hispanic than for White MSM (RR range = 1.50 [Tennessee] to 5.78 [Pennsylvania]). Rates of syphilis diagnoses were higher for Black than for White MSM in 42 of 44 states (state RR range = 0.89 [Hawaii] to 17.11 [Alaska]). Scatterplots of HIV diagnosis rates by race showed heterogeneity in epidemic scenarios, even in states with similar ratio-based disparity measures.
There is a widely disparate impact of HIV and syphilis among Black and Hispanic MSM compared with White MSM. Between-state variation suggests that states should tailor and focus their prevention responses to best address state data.
通过基于比例的衡量标准和差异图形描述,描述美国各州男男性行为者(MSM)中艾滋病毒感染和梅毒感染的差异。
我们使用了 2015 年和 2016 年报告的艾滋病毒和梅毒病例的州级监测数据,以及 MSM 人口规模的估计值,以估计按种族/族裔划分的艾滋病毒和梅毒流行率以及比率比(RR),并直观显示美国各州差异和流行率的模式。
与白人 MSM 相比,黑人 MSM 新诊断出的艾滋病毒感染率更高(RR 范围为 2.35[罗得岛]至 10.12[威斯康星州]),与白人 MSM 相比,西班牙裔 MSM 新诊断出的艾滋病毒感染率更高(RR 范围为 1.50[田纳西州]至 5.78[宾夕法尼亚州])。在 44 个州中的 42 个州(州 RR 范围为 0.89[夏威夷州]至 17.11[阿拉斯加州])中,梅毒诊断率黑人高于白人 MSM。按种族划分的艾滋病毒诊断率散点图显示,即使在基于比例的差异衡量标准相似的州,流行情况也存在异质性。
与白人 MSM 相比,黑人 MSM 和西班牙裔 MSM 中艾滋病毒和梅毒的影响差异很大。州际差异表明,各州应根据各自的数据情况,调整和集中预防应对措施。