Department of Health Behavior and Policy, Virginia Commonwealth University, Richmond, VA, USA.
AIDS Care. 2023 Dec;35(12):2007-2015. doi: 10.1080/09540121.2023.2189223. Epub 2023 Mar 16.
U.S. HIV diagnoses disproportionately affect Non-Hispanic Black (NHB) and Hispanic gay and bisexual men. Using data from the National Health Interview Survey (2013-2018), we examined race and ethnicity and primary care access, an HIV prevention resource, among gay and bisexual men. The explanatory variable was NHB, Hispanic or Non-Hispanic White (NHW). Outcomes were primary care-specific usual place of care (potential access) and saw general doctor <12 months (realized access). We used multivariable logistic regression, adjusting for individual sociodemographic characteristics, health status, and care barriers. In sensitivity analysis, we examined general access (any place/doctor) and subgroups (1) NHB (2) has usual place of care. The sample included 1,858 adult, gay and bisexual men (unweighted). Nearly one-third self-identified as NHB or Hispanic. Compared to NHW men, NHB and Hispanic men were younger, with lower household income, and more care barriers (< 0.05). NHB and Hispanic men had lower realized access (aOR 0.7058, = 0.030) than NHW men. Potential access was lower for NHB only (versus NHW) and, among those with any usual place of care, NHB and Hispanic men versus NHW men. Lower primary care access for NHB or Hispanic, rather than NHW, gay and bisexual men, may reduce HIV prevention access.
美国的艾滋病毒诊断率不成比例地影响到非西班牙裔黑人(NHB)和西班牙裔男同性恋和双性恋者。利用国家健康访谈调查(2013-2018 年)的数据,我们研究了男同性恋和双性恋者的种族和民族以及初级保健服务(艾滋病毒预防资源)的获得情况。解释变量是非西班牙裔黑人、西班牙裔或非西班牙裔白人(NHW)。结果是初级保健特定的常规护理地点(潜在获得)和在过去 12 个月内看过全科医生(实际获得)。我们使用多变量逻辑回归,调整了个人社会人口特征、健康状况和护理障碍。在敏感性分析中,我们检查了一般获得(任何地方/医生)和亚组(1)NHB(2)有常规护理地点。样本包括 1858 名成年男同性恋和双性恋者(未加权)。近三分之一的人自认为是非西班牙裔黑人或西班牙裔。与 NHW 男性相比,NHB 和西班牙裔男性更年轻,家庭收入更低,护理障碍更多(<0.05)。与 NHW 男性相比,NHB 和西班牙裔男性的实际获得率较低(aOR 0.7058,p=0.030)。只有 NHB 的潜在获得率较低(与 NHW 相比),而在有任何常规护理地点的人中,NHB 和西班牙裔男性与 NHW 男性相比。NHB 或西班牙裔男同性恋和双性恋者的初级保健服务获得率较低,可能会降低艾滋病毒预防服务的获得率。