Tran Nathan, Nishi Akihiro, Young Lindsay E, Endo Akira, Cumberland William G, Young Sean D
Department of Epidemiology, University of California, Los Angeles, Los Angeles, CA 90095, USA.
Annenberg School for Communication and Journalism, University of Southern California, Los Angeles, CA 90089, USA.
Prev Med Rep. 2023 Mar 31;33:102195. doi: 10.1016/j.pmedr.2023.102195. eCollection 2023 Jun.
Retention in healthcare and health behavior remains a critical issue, contributing to inequitable distribution of intervention benefits. In diseases such as HIV, where half of the new infections occur among racial and sexual minorities, it is important that interventions do not enlarge pre-existing health disparities. To effectively combat this public health issue, it is crucial that we quantify the magnitude of racial/ethnic disparity in retention. Further, there is a need to identify mediating factors to this relationship to inform equitable intervention design. In the present study, we assess the racial/ethnic disparity in retention in a peer-led online behavioral intervention to increase HIV self-testing behavior and identify explanatory factors. The research used data collected from the Harnessing Online Peer Education (HOPE) HIV Study that included 899 primarily African American and Latinx men who have sex with men (MSM) in the United States. Results show that African American participants had higher lost-to-follow-up rates at 12-week follow-up compared to Latinx participants (11.1% and 5.8% respectively, Odds Ratio = 2.18, 95% confidence interval: 1.12 - 4.11, = 0.02), which is substantially mediated by participants' self-rated health score (14.1% of the variation in the African American v.s. Latinx difference in lost-follow-up, = 0.006). Thus, how MSM perceive their health may play an important role in their retention in HIV-related behavioral intervention programs and its racial/ethnic disparity.
在医疗保健和健康行为方面的留存率仍然是一个关键问题，这导致了干预效益的不公平分配。在诸如艾滋病毒等疾病中，一半的新感染病例发生在少数族裔和性少数群体中，因此干预措施不扩大现有的健康差距至关重要。为了有效应对这一公共卫生问题，量化留存率方面种族/族裔差异的程度至关重要。此外，需要确定这种关系的中介因素，为公平的干预设计提供信息。在本研究中，我们评估了在一项由同伴主导的在线行为干预中，为增加艾滋病毒自我检测行为而进行的留存率方面的种族/族裔差异，并确定了解释因素。该研究使用了从“利用在线同伴教育（HOPE）艾滋病毒研究”中收集的数据，该研究包括美国899名主要为非裔美国人和拉丁裔男男性行为者（MSM）。结果显示，与拉丁裔参与者相比，非裔美国参与者在12周随访时的失访率更高（分别为11.1%和5.8%，优势比 = 2.18，95%置信区间：1.12 - 4.11，P = 0.02），这在很大程度上由参与者的自我健康评分所介导（非裔美国人和拉丁裔在失访差异中的14.1%的变异，P = 0.006）。因此，男男性行为者如何看待自己的健康状况可能在他们参与艾滋病毒相关行为干预项目及其种族/族裔差异方面发挥重要作用。
