Syndemic Health Disparities and Sexually Transmitted Infection Burden Among Black Men Who Have Sex with Men Engaged in Sex Work in the U.S.
Syndemic Health Disparities and Sexually Transmitted Infection Burden Among Black Men Who Have Sex with Men Engaged in Sex Work in the U.S.
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DOI：
10.1007/s10508-020-01828-2
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发表时间：
2021-05
影响因子：
3.8
通讯作者：
Friedman MR
中科院分区：
文献类型：
--
作者：
Chandler CJ;Meunier É;Eaton LA;Andrade E;Bukowski LA;Matthews DD;Raymond HF;Stall RD;Friedman MR
从事性工作的黑人男男性行为者（BMSM-SW）的艾滋病毒和性传播感染（STI）患病率升高。此外，BMSM-SW已被证明有较高的发病率的社会心理健康状况，这有助于艾滋病毒的风险行为和发病率，和较差的护理结果比其他群体的男性与男性发生性关系（MSM）。然而，尚未应用综合流行病学观点来了解美国BMSM-SW中过去一年的STI负担。2014-2017年期间，从美国六个城市（n=4421）的黑人骄傲活动中招募了≥ 18岁的性活跃黑人MSM。多变量logistic回归评估了过去一年性工作参与的相关性; BMSM-SW是否有更高的发病几率;以及BMSM-SW是否有更高的自我报告的过去一年STI诊断的几率。结构方程模型评估了性工作参与，并发症的条件，和STI控制的社会人口和性伴侣的数量之间的关系。254名（5.7%）黑人男男性接触者报告了过去一年的性工作，其中45.3%为艾滋病毒阳性。BMSM-SW更有可能是西班牙裔，报告过去一年的双性恋行为，并报告年收入<10，000美元。在多变量模型中，BMSM-SW更有可能报告亲密伴侣暴力，攻击受害，多种药物使用和抑郁症状;他们也更有可能报告去年的淋病，衣原体和梅毒。过去一年的性工作和过去一年的STI负担之间的关系，构成了一个显着的间接影响的综合症的条件介导。美国的BMSM-SW面临严重的生物心理社会健康差异。缺乏为从事性工作的BMSM制定的干预措施。我们的研究结果表明，包含安全性工作教育和性阳性生物行为艾滋病毒/性病预防以及药物使用，心理健康，就业和教育成分的干预措施将是最有效的。
Black MSM engaged in sex work (BMSM-SW) experience elevated HIV and sexually transmitted infection (STI) prevalence. Further, BMSM-SW have been shown to have higher rates of syndemic psychosocial health conditions which contribute to HIV risk behavior and incidence, and poorer care outcomes than other groups of men who have sex with men (MSM). However, syndemic perspectives have not been applied to understanding past-year STI burden among BMSM-SW in the U.S. Sexually active Black MSM ≥ 18 years old were recruited from Black Pride events in six U.S. cities (n=4421) between 2014–2017. Multivariable logistic regressions assessed correlates of past-year sex work engagement; whether BMSM-SW had higher odds of syndemic conditions; and whether BMSM-SW had higher odds of self-reported, past-year STI diagnoses. Structural equation models assessed relationships between sex work engagement, syndemic conditions, and STI controlled for sociodemographics and number of sexual partners. Two hundred fifty-four (5.7%) Black MSM reported past-year sex work, of whom 45.3% were HIV-positive. BMSM-SW were significantly more likely to be Hispanic, to report past-year bisexual behavior, and to report annual income <$10,000. In multivariable models, BMSM-SW were significantly more likely to report intimate partner violence, assault victimization, polydrug use, and depression symptoms; they were also more likely to report past-year gonorrhea, chlamydia, and syphilis. Syndemic conditions mediated the relationship between past-year sex work and past-year STI burden, constituting a significant indirect effect. BMSM-SW in the U.S. face severe biopsychosocial health disparities. Interventions developed for BMSM engaged in sex work are lacking. Our results suggest that interventions containing safer sex work education and sex positive biobehavioral HIV/STI prevention alongside substance use, mental health, employment, and education components will be most effective.
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DOI：
10.1080/08964289.2015.1110560
发表时间：
2016-07
期刊：
Behavioral medicine (Washington, D.C.)
影响因子：
--
作者：
Bauermeister J;Eaton L;Stephenson R
通讯作者：
Stephenson R
影响因子：
3.6
作者：
Hernández-Romieu AC;Siegler AJ;Sullivan PS;Crosby R;Rosenberg ES
通讯作者：
Rosenberg ES
影响因子：
8.4
作者：
dos Ramos Farias, Maria Sol;Noe Garcia, Maria;Mercedes Avila, Maria
通讯作者：
Mercedes Avila, Maria
影响因子：
3.8
作者：
Friedman MR;Bukowski L;Eaton LA;Matthews DD;Dyer TV;Siconolfi D;Stall R
通讯作者：
Stall R
影响因子：
4.4
作者：
Matthews DD;Herrick AL;Coulter RW;Friedman MR;Mills TC;Eaton LA;Wilson PA;Stall RD;POWER Study Team
通讯作者：
POWER Study Team