All authors are with the New York City Department of Health and Mental Hygiene, Queens, NY.
Am J Public Health. 2019 Sep;109(9):1212-1215. doi: 10.2105/AJPH.2019.305155. Epub 2019 Jul 18.
To quantify sociodemographic disparities in prediagnosis preexposure prophylaxis (PrEP) use in persons recently diagnosed with HIV in New York City and assigned for partner services. We used partner services data from November 2015 to September 2017 from persons diagnosed with HIV in the past 12 months (n = 3739) to compare individuals with self-reported or documented pre-HIV diagnosis PrEP use ("prediagnosis PrEP users") with those having none ("never users"). We constructed a penalized likelihood regression model generating sociodemographic predictors of prediagnosis PrEP use, employing Firth's adjustment for the rare outcome. We found report of prediagnosis PrEP use in 95 persons (3%). The adjusted odds ratios (AORs) of prediagnosis PrEP use were lower among non-Hispanic Blacks (AOR = 0.18; 95% confidence interval [CI] = 0.09, 0.32) and Hispanics (AOR = 0.31; 95% CI = 0.17, 0.55) than among non-Hispanic Whites, among persons aged 30 years or older (AOR = 0.45; 95% CI = 0.28, 0.72) than those younger than 30 years, among cis-women (AOR = 0.13; 95% CI = 0.02, 0.48) than cis-men, and among residents of Queens (AOR = 0.25; 95% CI = 0.10, 0.55) than those of Manhattan. Disparities in HIV prevention based on race/ethnicity, gender, age, and local geography may manifest themselves in differential PrEP use.
为了量化在纽约市最近被诊断出患有 HIV 并被分配接受伴侣服务的人群中，预先暴露前预防（PrEP）使用的社会人口统计学差异。我们使用了 2015 年 11 月至 2017 年 9 月期间，在过去 12 个月内被诊断出 HIV 的人群的伴侣服务数据（n=3739），将自我报告或记录的 HIV 诊断前 PrEP 使用情况（“诊断前 PrEP 用户”）的人与未使用过的人（“从未使用者”）进行比较。我们构建了一个惩罚似然回归模型，生成预先诊断 PrEP 使用的社会人口统计学预测因素，采用 Firth 调整方法来处理罕见结局。我们发现有 95 人（3%）报告了预先诊断 PrEP 使用情况。预先诊断 PrEP 使用的调整后优势比（AOR）在非西班牙裔黑人和西班牙裔人群中较低（AOR=0.18；95%置信区间[CI]0.09-0.32），而非非西班牙裔白人，在 30 岁或以上的人群中（AOR=0.45；95%CI0.28-0.72），而不是 30 岁以下的人群，在顺性别女性中（AOR=0.13；95%CI0.02-0.48），而不是顺性别男性，以及在皇后区（AOR=0.25；95%CI0.10-0.55）的居民中，而不是曼哈顿区的居民。基于种族/民族、性别、年龄和当地地理位置的 HIV 预防差异可能表现在差异 PrEP 使用上。
