Department of Population Health, School of Medicine, New York University, 180 Madison Ave, 3rd Floor, New York, NY, 10016, USA.
Department of Social and Behavioral Sciences, College of Global Public Health, New York University, New York, NY, USA.
AIDS Behav. 2019 Oct;23(10):2795-2802. doi: 10.1007/s10461-019-02609-2.
Despite an increasing pre-exposure prophylaxis (PrEP) use among populations at highest risk of HIV acquisition, comprehensive and easy access to PrEP is limited among racial/ethnic minorities and low-income populations. The present study analyzed the geographic distribution of PrEP providers and the relationship between their location, neighborhood characteristics, and HIV incidence using spatial analytic methods. PrEP provider density, socio-demographics, healthcare availability, and HIV incidence data were collected by ZIP-code tabulation area in New York City (NYC). Neighborhood socio-demographic measures of race/ethnicity, income, insurance coverage, or same-sex couple household, were not associated with PrEP provider density, after adjusting for spatial autocorrelation, and PrEP providers were located in high HIV incidence neighborhoods (P < 0.01). These findings validate the need for ongoing policy interventions (e.g. public health detailing) vis-à-vis PrEP provider locations in NYC and inform the design of future PrEP implementation strategies, such as public health campaigns and navigation assistance for low-cost insurance.
尽管在 HIV 感染风险最高的人群中,暴露前预防(PrEP)的使用逐渐增加,但少数族裔和低收入人群获得全面、便捷的 PrEP 服务仍然有限。本研究采用空间分析方法,分析了 PrEP 提供者的地理分布及其位置、社区特征与 HIV 发病率之间的关系。研究通过纽约市(NYC)的邮政编码区收集了 PrEP 提供者密度、社会人口统计学、医疗保健可用性和 HIV 发病率数据。在调整空间自相关后,发现社区种族/族裔、收入、保险覆盖范围或同性伴侣家庭等社会人口统计学指标与 PrEP 提供者密度无关,而且 PrEP 提供者位于 HIV 发病率较高的社区(P<0.01)。这些发现验证了需要针对 NYC 的 PrEP 提供者位置持续开展政策干预(例如公共卫生宣传),并为未来的 PrEP 实施策略(例如公共卫生宣传活动和低成本保险的导航协助)提供了信息。
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