Associations of race/ethnicity with HIV prevalence and HIV-related behaviors among young men who have sex with men in 7 urban centers in the United States
Associations of race/ethnicity with HIV prevalence and HIV-related behaviors among young men who have sex with men in 7 urban centers in the United States
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DOI：
10.1097/00126334-200404150-00011
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发表时间：
2004-04-15
影响因子：
3.6
通讯作者：
Valleroy, LA
中科院分区：
文献类型：
--
作者：
Harawa, NT;Greenland, S;Valleroy, LA
我们利用一项基于多个地点的调查数据，对15至22岁的男性受试者进行了调查，我们检查了3316名美国黑人、多民族黑人、拉丁裔和白人男男性行为者(MSM)在人口统计学、伴侣类型、特定伴侣类型避孕套使用、药物使用和艾滋病毒流行率方面的种族/民族差异。我们进一步估计了这些因素与艾滋病毒感染的关系，以及它们对艾滋病毒流行率的种族/民族差异的影响。黑人和多种族黑人参与者的艾滋病毒流行率为16%，拉丁裔为6.9%，白人为3.3%。矛盾的是，白人报告潜在危险的性行为和吸毒行为的频率最高，黑人报告的频率最低。在多元Logistic回归分析中，与HIV呈正相关的因素包括年龄较大、失学或失业、吸食强效可卡因时发生性行为以及与另一名男性发生肛交，而与报告的避孕套使用水平无关。这些因素的差异不能解释艾滋病毒流行率的种族/民族差异，两组黑人都经历了9次以上的感染，拉美裔感染的几率大约是白人的两倍。要了解艾滋病毒风险方面的种族/民族差异，需要了解传统风险行为和伙伴类型区别以外的信息。预防方案应针对稳定的伴侣关系中的风险，在与男性伴侣开始性行为之前以年轻男性为目标，并为有色人种和社会经济地位较低的男性量身定做干预措施。
Using data from a multisite venue-based survey of male subjects aged 15 to 22 years, we examined racial/ethnic differences in demographics, partner type, partner type-specific condom use, drug use, and HIV prevalence in 3316 US black, multiethnic black, Latino, and white men who have sex with men (MSM). We further estimated associations of these factors with HIV infection and their influence on racial/ethnic disparities in HIV prevalence. HIV prevalences were 16% for both black and multiethnic black participants, 6.9% for Latinos, and 3.3% for whites. Paradoxically, potentially risky sex and drug-using behaviors were generally reported most frequently by whites and least frequently by blacks. In a multiple logistic regression analysis, positive associations with HIV included older age, being out of school or work, sex while on crack cocaine, and anal sex with another male regardless of reported condom use level. Differences in these factors did not explain the racial/ethnic disparities in HIV prevalence, with both groups of blacks experiencing more than 9 times and Latinos experiencing approximately twice the fully adjusted odds of infection compared with whites. Understanding racial/ethnic disparities in HIV risk requires information beyond the traditional risk behavior and partnership type distinctions. Prevention programs should address risks in steady partnerships, target young men before sexual initiation with male partners, and tailor interventions to men of color and of lower socioeconomic status.