University of California, UCSF Mailcode 0886, 550 16th St., 3rd Floor, San Francisco, CA, 94158, USA.
Georgia State University, Atlanta, GA, USA.
AIDS Behav. 2019 Oct;23(10):2803-2815. doi: 10.1007/s10461-019-02630-5.
Although young Black men who have sex with men (YBMSM) are disproportionately affected by HIV, they may be more heterogeneous as a group than is typically appreciated. Thus, the present study used a person-centered data-analytic approach to determine profiles of HIV-related risk among YBMSM and whether these profiles could be distinguished by age, HIV status, and socioeconomic risk (i.e., socioeconomic distress). YBMSM (N = 1808) aged 18 to 29 years completed a survey of sociodemographic characteristics, HIV status, and HIV-related behavioral and attitudinal factors (i.e., safer-sex self-efficacy, negative condom attitudes, being in difficult sexual situations, being in difficult sexual relationships, HIV treatment optimism, perceived HIV stigma). Latent profile analysis was used to identify HIV risk profiles and whether age, HIV status, and socioeconomic distress were associated with these profiles. Four profiles emerged: low-, medium-, and high-risk profiles, respectively, and a mixed profile characterized by a tendency to be in difficult sexual situations and relationships while also reporting high safer-sex self-efficacy and low negative attitudes toward condom use. Difficult sexual situations emerged as the key defining indicator of whether a profile reflected higher or lower risk. Younger age, being HIV-positive, and socioeconomic distress were associated with having a higher-risk profile. Given that unique risk profiles emerged that were differentially predicted by sociodemographic characteristics and HIV status, these findings have implications for tailoring interventions to the needs of different subgroups of YBMSM. Also, disempowering or risky sexual situations and relationships among YBMSM must be addressed.
虽然与男性发生性关系的年轻黑人男性（YBMSM）不成比例地受到艾滋病毒的影响，但他们作为一个群体可能比人们通常认为的更加多样化。因此，本研究采用了以个体为中心的数据分析方法，以确定 YBMSM 中与 HIV 相关的风险特征，以及这些特征是否可以通过年龄、HIV 状况和社会经济风险（即社会经济困境）来区分。年龄在 18 至 29 岁的 YBMSM 完成了一项关于社会人口特征、HIV 状况以及与 HIV 相关的行为和态度因素（即安全性行为自我效能、对避孕套的消极态度、处于困难的性处境、处于困难的性关系、HIV 治疗乐观主义、感知的 HIV 耻辱感）的调查。潜在剖面分析用于识别 HIV 风险特征，以及年龄、HIV 状况和社会经济困境是否与这些特征相关。四个特征出现：低、中、高风险特征，以及一个混合特征，其特点是倾向于处于困难的性处境和关系，同时报告高安全性行为自我效能和低对避孕套使用的消极态度。困难的性处境成为反映特征反映更高或更低风险的关键定义指标。年轻、HIV 阳性和社会经济困境与更高风险特征有关。鉴于出现了独特的风险特征，这些特征可由社会人口特征和 HIV 状况预测，这些发现对根据 YBMSM 的不同亚组的需求定制干预措施具有影响。此外，必须解决 YBMSM 中权力丧失或危险的性处境和关系。
