Keralis Jessica M
Department of Epidemiology and Biostatistics, University of Maryland School of Public Health, 4200 Valley Dr, College Park, MD, 20742, USA.
AIDS Behav. 2023 Nov;27(11):3713-3724. doi: 10.1007/s10461-023-04087-z. Epub 2023 Jun 23.
The U.S. HIV epidemic disproportionately affects Black and Hispanic communities via ecosocial determinants of excess HIV risk, including HIV criminalization laws and overpolicing. This study used multilevel modeling to test the hypothesis that HIV criminalization laws are associated with higher county HIV incidence, and that this effect is modified by heavier county-level policing. County-level HIV incidence data from 2010 to 2019 were merged with county-level demographic, socioeconomic, and jailed population rate data for counties with stable HIV incidence rates (rates generated from a numerator of at least 12) for > 5 years. Multivariable multilevel (hierarchical) models for count-rate data were fitted, with years nested inside counties, and counties nested within states. An HIV criminalization law was associated with higher countywide HIV incidence rate for the general, Black, and Hispanic populations (aRR = 1.14, 1.30, and 1.32, respectively). This association was modified by an increased county jailed population rate for the general and Black populations.
美国的艾滋病疫情通过导致艾滋病风险过高的生态社会决定因素,包括艾滋病定罪法和过度执法,对黑人和西班牙裔社区造成了不成比例的影响。本研究采用多层次建模来检验以下假设:艾滋病定罪法与更高的县艾滋病发病率相关,并且这种影响会因县级执法力度加大而有所改变。将2010年至2019年的县级艾滋病发病率数据与艾滋病发病率稳定(发病率由至少12例分子得出)超过5年的县的县级人口统计、社会经济和监禁人口率数据合并。对计数率数据拟合多变量多层次(分层)模型,年份嵌套在县内,县嵌套在州内。艾滋病定罪法与普通人群、黑人和西班牙裔人群的全县艾滋病发病率较高相关(调整后风险比分别为1.14、1.30和1.32)。对于普通人群和黑人人群,这种关联因县监禁人口率增加而有所改变。