Strategic Information Division, HIV/AIDS, Hepatitis, STD, and TB Administration (HAHSTA), District of Columbia Department of Health, Government of the District of Columbia, Washington, DC, United States of America.
Department of Geography, University of Utah, Salt Lake City, Utah, United States of America.
PLoS One. 2021 Jul 22;16(7):e0253594. doi: 10.1371/journal.pone.0253594. eCollection 2021.
Social network strategies have been used by health departments to identify undiagnosed cases of HIV. Heterosexual cycle (HET4) of National HIV Behavioral Surveillance (NHBS) is a social network strategy implemented in jurisdictions. The main objectives of this research are to 1) evaluate the utility of the NHBS HET cycle data for network analysis; 2) to apply statistical analysis in support of previous HIV research, as well as to develop new research results focused on demographic variables and prevention/intervention with respect to heterosexual HIV risk; and 3) to employ NHBS data to inform policy with respect to the EHE plan.
We used data from the 2016 NHBS HET4 (DC). A total of 747 surveys were collected. We used the free social-network analysis package, GEPHI, for all network visualization using adjacency matrix representation. We additionally conducted logistic regression analysis to examine the association of selected variables with HIV status in three models representing 1) demographic and economic effects, 2) behavioral effects, and 3) prevention-intervention effects.
The results showed 3% were tested positive. Seed 1 initiated the largest networks with 426 nodes (15 positives); seed 4 with 273 nodes (6 positives). Seed 3 had 35 nodes (2 positives). All 23 HIV diagnoses were recruited from 4 zip-codes across DC. The risk of testing positive was higher among people high-school dropouts (Relative Risk (RR) (25.645); 95 CI% 5.699, 115.987), unemployed ((4.267); 1.295, 14.064), returning citizens ((14.319); 4.593, 44.645). We also found in the final model higher association of pre-exposure prophylaxis (PrEP) awareness among those tested negative ((4.783); 1.042, 21.944) and HIV intervention in the past 12 months with those tested positive ((17.887); 2.350,136.135).
The network visualization was used to address the primary aim of the analysis-evaluate the success of the implementation of the NHBS as a social network strategy to find new diagnoses. NHBS remains one of the strongest behavioral supplements for DC's HIV planning activities. As part of the evaluation process our analysis helps to understand the impact of demographic, behavioral, and prevention efforts on peoples' HIV status. We strongly recommend other jurisdictions use network visualizations to evaluate the efficacy in reaching hidden populations.
卫生部门利用社交网络策略来发现未确诊的艾滋病毒感染者。异性恋循环（HET4）是国家艾滋病毒行为监测（NHBS）中实施的一种社交网络策略。本研究的主要目的是：1）评估 NHBS HET 循环数据在网络分析中的实用性；2）利用统计分析支持先前的艾滋病毒研究，并开发新的研究结果，重点关注与异性恋艾滋病毒风险相关的人口统计学变量和预防/干预措施；3）利用 NHBS 数据为 EHE 计划提供政策参考。
我们使用了 2016 年 NHBS HET4（华盛顿特区）的数据。共收集了 747 份调查。我们使用免费的社交网络分析软件 Gephi ，通过邻接矩阵表示进行所有网络可视化。我们还进行了逻辑回归分析，以在三个模型中检查选定变量与 HIV 状况之间的关联，这三个模型分别代表 1）人口统计学和经济效应，2）行为效应，3）预防/干预效应。
结果显示，有 3%的人检测呈阳性。种子 1 发起的网络最大，有 426 个节点（15 个阳性）；种子 4 有 273 个节点（6 个阳性）。种子 3 有 35 个节点（2 个阳性）。所有 23 例艾滋病毒诊断均来自特区的 4 个邮政编码。与高中辍学者（相对风险（RR）（25.645）；95%置信区间（CI）为 5.699，115.987）、失业者（4.267）；1.295，14.064）、回归公民（14.319）；4.593，44.645）相比，检测呈阳性的风险更高。我们还发现，在最后一个模型中，在过去 12 个月中，检测呈阴性者对暴露前预防（PrEP）的认识（4.783）；1.042，21.944）和艾滋病毒干预措施与检测呈阳性者（17.887）；2.350，136.135）之间的相关性更高。
网络可视化用于解决分析的主要目标——评估 NHBS 作为发现新诊断的社交网络策略的实施成功。NHBS 仍然是特区艾滋病毒规划活动的最强有力的行为补充之一。作为评估过程的一部分，我们的分析有助于了解人口统计学、行为和预防工作对人们艾滋病毒状况的影响。我们强烈建议其他司法管辖区使用网络可视化来评估接触隐藏人群的效果。
