Influence of residential segregation on survival after AIDS diagnosis among non-Hispanic blacks.
Influence of residential segregation on survival after AIDS diagnosis among non-Hispanic blacks.
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DOI：
10.1016/j.annepidem.2014.11.023
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发表时间：
2015-02
影响因子：
5.6
通讯作者：
Trepka, Mary Jo
中科院分区：
文献类型：
--
作者：
Fennie, Kristopher P.;Lutfi, Khaleeq;Maddox, Lorene M.;Lieb, Spencer;Trepka, Mary Jo
非西班牙裔黑人（NHBs）不成比例地受到艾滋病流行病的影响。随着高效抗逆转录病毒治疗（HAART）的出现，艾滋病诊断后的生存率显著提高，但与非西班牙裔白人相比，nhb的生存率较短。种族居住隔离可能是影响观察到的种族生存差异的重要因素。我们将来自佛罗里达州卫生部HIV/AIDS报告系统（1993-2004）的30,813家nhb的数据与死亡记录联系起来，并对数据应用隔离指数和贫困水平。在控制人口因素、临床因素和地区贫困的情况下，使用加权Cox模型来检验在五个维度上测量的隔离与生存率之间的关系。分析按HAART前（1993-1995）、早期HAART（1996-1998）和晚期HAART（1999-2004）进行分层。在haartera晚期，对地区贫困水平进行调整后，隔离在两个维度上仍然是生存的重要预测因子：集中度（风险比，1.32；95%可信区间，1.13-1.56）和集中度（风险比，1.44,95%可信区间，1.12-1.84）。地区贫困是一个独立的生存预测指标。这些发现表明，隔离和贫困的某些方面与艾滋病诊断后的生存有关。
Non-Hispanic blacks (NHBs) are disproportionately affected by the AIDS epidemic. With the advent of highly active antiretroviral therapy (HAART), survival after AIDS diagnosis has increased dramatically, yet survival among NHBs is shorter compared with non-Hispanic whites. Racial residential segregation may be an important factor influencing observed racial disparities in survival. We linked data on 30,813 NHBs from the Florida Department of Health HIV/AIDS Reporting system (1993–2004) with death records and applied segregation indices and poverty levels to the data. Weighted Cox models were used to examine the association between segregation measured on five dimensions and survival, controlling for demographic factors, clinical factors, and area-level poverty. Analyses were stratified by pre-HAART (1993–1995), early HAART (1996–1998), and late-HAART (1999–2004) eras. In the late-HAARTera, adjusting for area-level poverty, segregation remained a significant predictor of survival on two dimensions: Concentration (hazard ratio, 1.32; 95% confidence interval, 1.13–1.56) and centralization (hazard ratio, 1.44; 95% confidence interval, 1.12–1.84). Area-level poverty was an independent predictor of survival. These findings suggest that certain dimensions of segregation and poverty are associated with survival after AIDS diagnosis.
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影响因子：
5.5
作者：
Kramer MR;Hogue CR
通讯作者：
Hogue CR
影响因子：
5.4
作者：
Chang, Virginia W.
通讯作者：
Chang, Virginia W.
DOI：
10.1097/qai.0b013e3181b563e7
发表时间：
2010-01-01
影响因子：
3.6
作者：
Harrison, Kathleen McDavid;Song, Ruiguang;Zhang, Xinjian
通讯作者：
Zhang, Xinjian
影响因子：
11.8
作者：
Losina, Elena;Schackman, Bruce R.;Freedberg, Kenneth A.
通讯作者：
Freedberg, Kenneth A.
影响因子：
3.5
作者：
MASSEY, DS;DENTON, NA
通讯作者：
DENTON, NA