Jefferson Kevin A, Kersanske Laura S, Wolfe Mary E, Braunstein Sarah L, Haardörfer Regine, Des Jarlais Don C, Campbell Aimee N C, Cooper Hannah Lf
a Behavioral Sciences and Health Education , Rollins School of Public Health at Emory University , Atlanta , USA.
b New York City Department of Health and Mental Hygiene , Queens , USA.
AIDS Care. 2019 Jul;31(7):864-874. doi: 10.1080/09540121.2018.1545989. Epub 2018 Nov 26.
Scant research has explored place-based correlates of achieving and maintaining HIV viral load suppression among heterosexuals living with HIV. We conducted multilevel analyses to examine associations between United Hospital Fund (UHF)-level characteristics and individual-level viral suppression and durable viral suppression among individuals with newly diagnosed HIV in New York City (NYC) who have heterosexual HIV transmission risk. Individual-level independent and dependent variables came from NYC's HIV surveillance registry for individuals diagnosed with HIV in 2009-2013 (N = 3,159; 57% virally suppressed; 36% durably virally suppressed). UHF-level covariates included measures of food distress, demographic composition, neighborhood disadvantage and affluence, healthcare access, alcohol outlet density, residential vacancy, and police stop and frisk rates. We found that living in neighborhoods where a larger percent of residents were food distressed was associated with not maintaining viral suppression. If future research should confirm this is a causal association, community-level interventions targeting food distress may improve the health of people living with HIV and reduce the risk of forward transmission.
针对感染艾滋病毒的异性恋者实现并维持艾滋病毒病毒载量抑制的基于地点的相关因素，目前研究甚少。我们进行了多层次分析，以检验纽约市（NYC）有异性传播艾滋病毒风险且新诊断出感染艾滋病毒的个体中，联合医院基金（UHF）层面的特征与个体层面的病毒抑制及持久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2009 - 2013年艾滋病毒监测登记册（N = 3159；57%实现病毒抑制；36%实现持久病毒抑制）。UHF层面的协变量包括食物困境、人口构成、邻里劣势与富裕程度、医疗服务可及性、酒精销售点密度、住宅空置率以及警察拦截搜身率等指标。我们发现，居住在食物困境居民比例较高社区的个体，与无法维持病毒抑制有关。如果未来研究证实这是一种因果关联，针对食物困境的社区层面干预措施可能会改善艾滋病毒感染者的健康状况，并降低病毒进一步传播的风险。
