Understanding disparities in HIV infection between black and white MSM in the United States
Understanding disparities in HIV infection between black and white MSM in the United States
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DOI：
10.1097/qad.0b013e3283471efa
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发表时间：
2011-05-15
期刊：
影响因子：
3.8
通讯作者：
Millett, Gregorio A.
中科院分区：
文献类型：
--
作者：
Oster, Alexandra M.;Wiegand, Ryan E.;Millett, Gregorio A.
目的：我们评估了几个假设之间的差距在艾滋病毒感染黑人和白色男男性行为者在美国，包括监禁，合作伙伴的艾滋病毒状态，包皮环切术，性网络，和持续时间的infectiousness.Design：2008年国家艾滋病毒行为监测系统（NHBS），在21个美国countries.Methods进行横断面调查：男男性行为者进行了采访和测试艾滋病毒感染。对于既往未诊断为HIV感染的MSM，我们使用逻辑回归来检验新诊断的HIV感染与监禁史、伴侣HIV状态、包皮环切状态和性网络（老年伴侣、并发症和伴侣风险行为）之间的关联。对于HIV感染的男男性接触者，我们评估了与传染性持续时间相关的因素。结果：在5183男男性接触者中，既往未被诊断为HIV感染者，监禁史，包皮环切术状态和性网络与HIV感染无关。有HIV感染的伴侣[校正比值比（AOR）= 1.9，95%可信区间（CI）= 1.2-3.0]或未知状态的伴侣（AOR = 1.4，CI = 1.1-1.7）与HIV感染有关。在这两个因素中，只有一个在黑人男男性行为者中更为常见--有艾滋病毒感染状况不明的伴侣。在既往诊断为HIV阳性的MSM中，黑人MSM接受抗逆转录病毒治疗（ART）的可能性较小。结论：黑人MSM对伴侣HIV感染状况了解较少，ART使用率较低，这可能部分解释了黑人MSM与白色MSM之间HIV感染的差异。努力鼓励男男性行为者及其伴侣之间讨论艾滋病毒状况，并减少黑人男男性行为者接受抗逆转录病毒治疗的障碍，可能会减少传播。(C)2011威科健康垂直酒吧Lippincott威廉姆斯& Wilkins
Objective: We evaluated several hypotheses for disparities in HIV infection between black and white MSM in the United States, including incarceration, partner HIV status, circumcision, sexual networks, and duration of infectiousness.Design: The 2008 National HIV Behavioral Surveillance System (NHBS), a cross-sectional survey conducted in 21 US cities.Methods: MSM were interviewed and tested for HIV infection. For MSM not previously diagnosed with HIV infection, we used logistic regression to test associations between newly diagnosed HIV infection and incarceration history, partner HIV status, circumcision status, and sexual networks (older partners, concurrency, and partner risk behaviors). For HIV-infected MSM, we assessed factors related to duration of infectiousness.Results: Among 5183 MSM not previously diagnosed with HIV infection, incarceration history, circumcision status, and sexual networks were not independently associated with HIV infection. Having HIV-infected partners [adjusted odds ratio (AOR) = 1.9, 95% confidence interval (CI) = 1.2-3.0] or partners of unknown status (AOR = 1.4, CI = 1.1-1.7) were associated with HIV infection. Of these two factors, only one was more common among black MSM - having partners of unknown HIV status. Among previously diagnosed HIV-positive MSM, black MSM were less likely to be on anti-retroviral therapy (ART).Conclusion: Less knowledge of partner HIV status and lower ART use among black MSM may partially explain differences in HIV infection between black and white MSM. Efforts to encourage discussions about HIV status between MSM and their partners and decrease barriers to ART provision among black MSM may decrease transmission. (C) 2011 Wolters Kluwer Health vertical bar Lippincott Williams & Wilkins