Department of Behavioral, Social and Health Education Sciences, Rollins School of Public Health, Emory University, Atlanta, GA.
Department of Behavioral, Social and Health Education Sciences, Rollins School of Public Health, Emory University, Atlanta, GA.
Ann Epidemiol. 2021 Mar;55:69-77.e5. doi: 10.1016/j.annepidem.2020.10.003. Epub 2020 Oct 14.
To assess cross-population linkages in HIV/AIDS epidemics, we tested the hypothesis that the number of newly diagnosed AIDS cases among Black people who inject drugs (PWID) was positively related to the natural log of the rate of newly diagnosed HIV infections among Black non-PWID heterosexuals in 84 large U.S. metropolitan statistical areas (MSAs) in 2008-2016.
We estimated a multilevel model centering the time-varying continuous exposures at baseline between the independent (Black PWID AIDS rates) and dependent (HIV diagnoses rate among Black heterosexuals) variables.
At MSA level, baseline (standardized β = 0.12) Black PWID AIDS rates and change in these rates over time (standardized β = 0.11) were positively associated with the log of new HIV diagnoses rates among Black heterosexuals. Thus, MSAs with Black PWID AIDS rates that were 1 standard deviation= higher at baseline also had rates of newly diagnosed HIV infections among Black non-PWID heterosexuals that were 10.3% higher. A 1 standard deviation increase in independent variable over time corresponded to a 7.8% increase in dependent variable.
Black PWID AIDS rates may predict HIV rates among non-PWID Black heterosexuals. Effective HIV programming may be predicated, in part, on addressing intertwining of HIV epidemics across populations.
为了评估艾滋病毒/艾滋病流行中的跨人群关联，我们检验了以下假设，即在 2008 年至 2016 年间，84 个美国大都市区（MSA）中，新诊断的注射吸毒黑人艾滋病病例（PWID）数量与黑人异性恋非 PWID 中新诊断的 HIV 感染率的自然对数呈正相关。
我们在基线时对随时间变化的连续暴露进行了多水平模型估计，将独立变量（黑人 PWID 艾滋病率）和因变量（黑人异性恋者中的 HIV 诊断率）置于中心位置。
在 MSA 层面上，基线时（标准化β=0.12）黑人 PWID 艾滋病率和这些率随时间的变化（标准化β=0.11）与黑人异性恋者中新诊断的 HIV 诊断率的对数呈正相关。因此，基线时黑人 PWID 艾滋病率高出 1 个标准差的 MSA，其黑人非 PWID 异性恋者中新诊断的 HIV 感染率也高出 10.3%。独立变量随时间的 1 个标准差增加对应于因变量的 7.8%增加。
黑人 PWID 艾滋病率可能预测黑人非 PWID 异性恋者中的 HIV 率。有效的 HIV 规划可能部分取决于解决不同人群中 HIV 流行的交织问题。
