佛罗里达州坦帕湾青少年和年轻成人中的 HIV 检测荒漠和脆弱性。
HIV Testing Deserts and Vulnerability Among Adolescents and Young Adults in Tampa Bay, Florida.
机构信息
Johns Hopkins University School of Medicine, Baltimore, Maryland.
Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore Maryland; Institute for Clinical and Translational Research, Johns Hopkins All Children's Hospital, St. Petersburg, Florida.
出版信息
J Adolesc Health. 2024 May;74(5):1012-1018. doi: 10.1016/j.jadohealth.2024.01.011. Epub 2024 Feb 29.
PURPOSE
Human immunodeficiency virus (HIV) burden among Florida adolescents and young adults (AYA, aged 13-24 years), particularly in Tampa Bay, is among the highest in the nation. We sought to determine the association between zip code-level test site accessibility and AYA HIV burden, compare this association with adult (aged 25-44 years) HIV burden, and identify local AYA HIV testing deserts. We further aimed to identify the association between test site accessibility and population-level markers of social disadvantage.
METHODS
We geocoded HIV test sites and determined the percent surface area per zip code within 15-minute walking distance to ≥ 1 test sites (PSA15) in Pinellas and Hillsborough counties. We calculated Pearson's correlation coefficients for the association of PSA15 and HIV burden by age group and, separately, the association of PSA15 and population-level characteristics.
RESULTS
Of the 96 zip codes analyzed, 36.5% had a PSA15 for HIV testing of 0%. The association between PSA15 and HIV burden was substantially higher for adults (r = 0.51, p < .001) than for AYA (r = 0.09, p = .38). Overall, we identified four potential AYA testing deserts. We also found that greater PSA15 was correlated with greater %Black/African-American residents (r = 0.32, p = .002), greater %residents living in poverty (r = 0.27, p = .008), and lower child opportunity index scores (r = -0.29, p = .004).
DISCUSSION
Walking-accessible HIV test sites in Tampa Bay were limited and geographically distributed largely based on adult HIV burden, population-level markers of social disadvantage, and among areas with higher percentages of Black/African-American residents. Test site distribution was less correlated with AYA HIV burden, leaving this population vulnerable across multiple testing deserts.
目的
佛罗里达州的青少年和年轻人(13-24 岁,简称 AYA)以及成年人(25-44 岁)中的艾滋病毒(HIV)负担率位居全美前列,尤其是在坦帕湾地区。我们旨在确定邮政编码层面检测点可达性与 AYA HIV 负担之间的关联,并将其与成年人 HIV 负担进行比较,同时识别当地 AYA HIV 检测荒漠。此外,我们还旨在确定检测点可达性与人口水平社会劣势指标之间的关联。
方法
我们对 HIV 检测点进行地理编码,并确定了皮内拉斯县和希尔斯伯勒县每个邮政编码区域内,15 分钟步行距离内(PSA15)至少有 1 个检测点的面积百分比。我们计算了 PSA15 与按年龄组划分的 HIV 负担之间的 Pearson 相关系数,以及 PSA15 与人口水平特征之间的关联。
结果
在所分析的 96 个邮政编码中,36.5%的地区 PSA15 为 0%,这意味着没有足够的步行可达的 HIV 检测点。PSA15 与成人 HIV 负担之间的关联(r = 0.51,p <.001)显著高于 AYA(r = 0.09,p =.38)。总的来说,我们发现了四个潜在的 AYA 检测荒漠。我们还发现,PSA15 越大,黑人和非洲裔美国人居民的比例就越高(r = 0.32,p =.002),生活在贫困中的居民比例也越高(r = 0.27,p =.008),儿童机会指数得分越低(r = -0.29,p =.004)。
讨论
坦帕湾地区可步行到达的 HIV 检测点数量有限,其地理位置主要基于成人 HIV 负担、人口水平社会劣势指标以及黑人和非洲裔美国人居民比例较高的地区分布。检测点的分布与 AYA HIV 负担的相关性较低,这使得该人群在多个检测荒漠地区都面临脆弱性。
相似文献
J Adolesc Health. 2024-5
AIDS Patient Care STDS. 2014-3-24
本文引用的文献
Sex Res Social Policy. 2022
J Acquir Immune Defic Syndr. 2021-12-1
J Am Pharm Assoc (2003). 2021
Environ Plann B Plann Des. 2003-12
JAMA. 2019-3-5
BMC Health Serv Res. 2018-3-27
Health Aff (Millwood). 2014-11