Ramirez Yanil V, Saltos Gisella M Drouet, Crawford Timothy N
Wright State University Boonshoft School of Medicine, Dayton, OH, USA.
Wright State University Boonshoft School of Medicine, Population and Public Health Sciences, Dayton, OH, USA.
J Racial Ethn Health Disparities. 2024 Sep 4. doi: 10.1007/s40615-024-02158-y.
Resource insecurity is a social determinant of health that can impact people with HIV (PWH), in particular older African Americans (AA) or blacks with HIV. The purpose of this study was to identify resource insecurities among older Blacks or AA PWH specifically related to food and housing. Secondary focus was to find associations between resource insecurity and substance use history, stigma, and various forms of discrimination.
Eligible participants (N = 52) of this cross-sectional study were 50 years old or older, identified as Black or AA, diagnosed with HIV, and living in Ohio. Food insecurity was assessed using the Household Food Insecurity Access Scale and housing insecurity was defined as not having stable housing. Resource insecurity was categorized into food and housing secure, food or housing insecure, and food and housing insecure.
Almost half (48.1%) of participants reported housing insecurity, with approximately 58.0% experiencing food insecurity, and 38.5% facing both. Current substance use, particularly opiates, showed significant association with resource insecurity (OR = 5.54; 95% CI = 1.91-17.30). Moreover, experiences of everyday (OR = 1.19; 95% CI = 1.10-1.30) or major forms (OR = 1.75; 95% CI = 1.33-2.39) of discrimination, as well as HIV stigma (OR = 1.24; 95% CI = 1.01-1.55), were also linked to increased odds of resource insecurity among participants.
Findings highlight how social factors contribute to resource insecurity among older AA PWH. Understanding the factors offers insight for targeted intervention in the fight against HIV transmission.
资源不安全是一种健康的社会决定因素,可能会影响艾滋病毒感染者(PWH),尤其是老年非裔美国人(AA)或感染艾滋病毒的黑人。本研究的目的是确定老年黑人或感染艾滋病毒的非裔美国人中与食物和住房具体相关的资源不安全状况。次要重点是找出资源不安全与物质使用史、耻辱感和各种形式歧视之间的关联。
这项横断面研究的符合条件的参与者(N = 52)年龄在50岁及以上,被确定为黑人或非裔美国人,被诊断出感染艾滋病毒,且居住在俄亥俄州。使用家庭粮食不安全获取量表评估粮食不安全状况,住房不安全被定义为没有稳定住房。资源不安全被分为粮食和住房安全、粮食或住房不安全以及粮食和住房都不安全。
近一半(48.1%)的参与者报告住房不安全,约58.0%经历粮食不安全,38.5%面临两者都不安全的情况。当前的物质使用,尤其是阿片类药物,与资源不安全有显著关联(OR = 5.54;95% CI = 1.91 - 17.30)。此外,日常(OR = 1.19;95% CI = 1.10 - 1.30)或主要形式(OR = 1.75;95% CI = 1.33 - 2.39)的歧视经历以及艾滋病毒耻辱感(OR = 1.24;95% CI = 1.01 - 1.55)也与参与者中资源不安全几率的增加有关。
研究结果突出了社会因素如何导致老年非裔美国艾滋病毒感染者的资源不安全。了解这些因素为抗击艾滋病毒传播的有针对性干预提供了见解。