The Human Immunodeficiency Virus Endemic: Maintaining Disease Transmission in At-Risk Urban Areas.
The Human Immunodeficiency Virus Endemic: Maintaining Disease Transmission in At-Risk Urban Areas.
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DOI：
10.1097/olq.0000000000000561
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发表时间：
2017-02
影响因子：
3.1
通讯作者：
Heath JW
中科院分区：
文献类型：
--
作者：
Rothenberg RB;Dai D;Adams MA;Heath JW
一项关于网络关系、地理邻接性和风险行为的研究旨在检验这三项都是维持艾滋病毒在高危城市社区的地方性所必需的假设。具体地说，将需要高度互动的网络、地理上的接近和复合风险(有多个合作伙伴的多个高风险活动)。我们从佐治亚州亚特兰大的两个连续地理区域招募了927名参与者：根据艾滋病毒报告史衡量，这两个地区分别是高风险地区和低风险地区。我们首先招募了30名在人口统计和行为特征上具有可比性的“种子”(每个地区15名)，并使用链式设计构建了30个网络。我们评估了每个人的地理范围；测量了高风险地区和低风险地区的网络特征；并测量了复合风险，即存在两个或更多(六个中)艾滋病毒的主要风险。在高风险地区的参与者中，复合风险的频率为15%，而在低风险地区为5%。根据地理距离和社会距离的比较，以及个人地理范围的重叠程度，高风险组的地理凝聚力显著高于低风险组。这两个地区的网络是相似的：两个地区都显示出高度互动的网络，具有相似的程度分布，并且大多数网络属性的测量实际上是相同的。我们最初的假设得到了部分支持。高风险组和低风险组在风险和地理凝聚力方面存在显著差异，但在网络属性方面基本相同。这些结果表明，维持地方性传播可能需要“最低”的网络配置，但特定的流行水平可能由与风险、地理和可能的其他因素有关的因素决定。
A study of network relationships, geographic contiguity, and risk behavior was designed to test the hypothesis that all three are required to maintain endemicity of HIV in at-risk urban communities. Specifically, a highly interactive network, close geographic proximity, and compound risk (multiple high risk activities with multiple partners) would be required. We enrolled 927 participants from two contiguous geographic areas in Atlanta, GA: a higher risk area and lower risk area, as measured by history of HIV reporting. We began by enrolling 30 “seeds” (15 in each area) who were comparable in their demographic and behavioral characteristics, and constructed 30 networks using a chain-link design. We assessed each individual’s geographic range; measured the network characteristics of those in the higher and lower risk areas; and measured compound risk as the presence of two or more (out of six) major risks for HIV. Among participants in the higher risk area, the frequency of compound risk was 15%, compared to 5% in the lower risk area. Geographic cohesion in the higher risk group was substantially higher than that in the lower risk group, based on comparison of geographic distance and social distance, and on the extent of overlap of personal geographic range. The networks in the two areas were similar: both areas show highly interactive networks with similar degree distributions, and most measures of network attributes were virtually the same. Our original hypothesis was supported in part. The higher and lower risk groups differed appreciably with regard to risk and geographic cohesion, but were substantially the same with regard to network properties. These results suggest that a “minimum” network configuration may be required for maintenance of endemic transmission, but a particular prevalence level may be determined by factors related to risk, geography, and possibly other factors.