J Health Care Poor Underserved. 2020;31(1):455-470. doi: 10.1353/hpu.2020.0033.
Black populations in the United States are disproportionately affected by HIV. This disparity may be affected by social and structural barriers to HIV testing, leading to undiagnosed infection and prolonged HIV transmissibility. Using data from a nationally representative sample of 1,727 Black men in the 2015 Behavioral Risk Factor Surveillance System we tested for differences in poverty, depression, and health care barriers between Black men who had been HIV tested in the past year and those who had not. We also tested a syndemic index of these factors. Number of syndemic factors was linearly associated with less HIV testing (aPR=0.79, 95% CI 0.66-0.95). Assumptions of unidimensionality were met. The use of a syndemic index was a superior approach to analyzing these factors individually, both in terms of model fit and associations detected. The accumulation of poverty, depression, and health care barriers has an adverse impact on HIV testing among Black men.
美国的黑人群体受到艾滋病毒的影响不成比例。这种差异可能受到艾滋病毒检测的社会和结构性障碍的影响，导致未确诊的感染和艾滋病毒传播时间延长。我们使用来自 2015 年行为风险因素监测系统中 1727 名黑人男性的全国代表性样本数据，检验了过去一年接受过艾滋病毒检测的黑人男性与未接受过艾滋病毒检测的黑人男性在贫困、抑郁和医疗保健障碍方面的差异。我们还测试了这些因素的综合征指数。综合征因素的数量与艾滋病毒检测次数呈线性相关（aPR=0.79，95%CI 0.66-0.95）。满足了单维性假设。使用综合征指数分析这些因素比单独分析这些因素在模型拟合和检测到的关联方面都更具优势。贫困、抑郁和医疗保健障碍的积累对黑人男性的艾滋病毒检测产生了不利影响。
