Disparities in Care Outcomes in Atlanta Between Black and White Men Who Have Sex With Men Living With HIV: Protocol for a Prospective Cohort Study (Engage[men]t).
Disparities in Care Outcomes in Atlanta Between Black and White Men Who Have Sex With Men Living With HIV: Protocol for a Prospective Cohort Study (Engage[men]t).
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DOI：
10.2196/21985
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发表时间：
2021-02-23
影响因子：
1.7
通讯作者：
Kelley C
中科院分区：
文献类型：
--
作者：
Sullivan PS;Taussig J;Valentine-Graves M;Luisi N;Del Rio C;Guest JL;Jones J;Millett G;Rosenberg ES;Stephenson R;Kelley C
美国艾滋病毒流行是由男男性行为者感染驱动的，其特点是美国黑人的艾滋病毒流行率和结果存在巨大差异。据报道，与艾滋病毒感染者发生性关系的黑人男性的护理结果比其他男男性行为者的情况更差，但造成这些健康不平等的原因尚不清楚。我们计划进行一项前瞻性观察队列研究，以帮助了解亚特兰大男男性行为黑人与白人男性的艾滋病毒护理结果较差的原因。本研究的目的是确定个人、二元、网络、社区和结构因素，以解释亚特兰大与艾滋病毒感染者发生性行为的黑人和白人之间艾滋病毒病毒抑制的差异。与艾滋病毒感染者发生性关系的黑人和白人参加了一项前瞻性队列研究，在基线、12 个月和 24 个月进行了现场访问和病毒抑制评估； 3、6 和 18 个月时的护理和风险行为的额外调查；通过公共卫生报告分析研究之外接受的护理；对研究期间经历过哨点健康事件（例如病毒抑制丧失）的参与者进行定性访谈。该研究基于布朗芬布伦纳社会生态理论模型。 2016 年 6 月至 2017 年 6 月期间，亚特兰大招募了男男性行为者 (n=400)。 2019年6月完成随访； 24 个月时，最终学习保留率为 80%。据推测，男男性行为黑人的健康差异是由结构性种族主义和护理障碍造成的。观察性研究对于记录和量化社会生态框架内导致病毒抑制差异的具体因素非常重要。与此同时，推动采取措施改善获得医疗服务的机会也至关重要，包括在乔治亚州等南部各州扩大医疗补助，这些州尚未采取行动扩大医疗补助。 DERR1-10.2196/21985
The US HIV epidemic is driven by infections in men who have sex with men and characterized by profound disparities in HIV prevalence and outcomes for Black Americans. Black men who have sex with men living with HIV are reported to have worse care outcomes than other men who have sex with men, but the reasons for these health inequities are not clear. We planned a prospective observational cohort study to help understand the reasons for worse HIV care outcomes for Black versus White men who have sex with men in Atlanta. The aim of this study is to identify individual, dyadic, network, neighborhood, and structural factors that explain disparities in HIV viral suppression between Black and White men who have sex with men living with HIV in Atlanta. Black and White men who have sex with men living with HIV were enrolled in a prospective cohort study with in-person visits and viral suppression assessments at baseline, 12 months, and 24 months; additional surveys of care and risk behaviors at 3, 6, and 18 months; analysis of care received outside the study through public health reporting; and qualitative interviews for participants who experienced sentinel health events (eg, loss of viral suppression) during the study. The study is based on the Bronfenbrenner socioecological theoretical model. Men who have sex with men (n=400) were enrolled between June 2016 and June 2017 in Atlanta. Follow-up was completed in June 2019; final study retention was 80% at 24 months. Health disparities for Black men who have sex with men are hypothesized to be driven by structural racism and barriers to care. Observational studies are important to document and quantify the specific factors within the socioecological framework that account for disparities in viral suppression. In the meantime, it is also critical to push for steps to improve access to care, including Medicaid expansion in Southern states, such as Georgia, which have not yet moved to expand Medicaid. DERR1-10.2196/21985
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影响因子：
7.6
作者：
BARON, RM;KENNY, DA
通讯作者：
KENNY, DA
DOI：
10.1097/qai.0000000000001242
发表时间：
2017-02-01
期刊：
Journal of acquired immune deficiency syndromes (1999)
影响因子：
--
作者：
Colasanti J;Stahl N;Farber EW;Del Rio C;Armstrong WS
通讯作者：
Armstrong WS
DOI：
10.2217/hiv.09.33
发表时间：
2009-09-01
期刊：
HIV Therapy
影响因子：
--
作者：
Baernighausen, Till;Tanser, Frank
通讯作者：
Tanser, Frank
影响因子：
4.4
作者：
Hall, H. Irene;Holtgrave, David R.;Rhodes, Philip
通讯作者：
Rhodes, Philip
影响因子：
3.7
作者：
Kelley CF;Rosenberg ES;O'Hara BM;Frew PM;Sanchez T;Peterson JL;Del Rio C;Sullivan PS
通讯作者：
Sullivan PS