Lack of Awareness of Human Immunodeficiency Virus (HIV) Infection: Problems and Solutions With Self-reported HIV Serostatus of Men Who Have Sex With Men.
Lack of Awareness of Human Immunodeficiency Virus (HIV) Infection: Problems and Solutions With Self-reported HIV Serostatus of Men Who Have Sex With Men.
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DOI：
10.1093/ofid/ofu084
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发表时间：
2014-09
影响因子：
4.2
通讯作者：
Sullivan PS
中科院分区：
文献类型：
--
作者：
Sanchez TH;Kelley CF;Rosenberg E;Luisi N;O'Hara B;Lambert R;Coleman R;Frew P;Salazar LF;Tao S;Clarke W;Del Rio C;Sullivan PS
仅使用自我报告的信息可能高估了黑人男同性恋者对艾滋病毒状况缺乏认识。同时纳入实验室和病例监测措施的估计并未显示在缺乏艾滋病毒状况认识方面存在显著的种族差异。缺乏对人类免疫缺陷病毒（HIV）感染的认识可能是男男性行为者（MSM）中艾滋病毒感染的种族差异的一个驱动因素。通常通过比较艾滋病毒检测结果与自我报告的艾滋病毒状况来衡量缺乏意识。该方法可能存在报道偏差，需要替代方法。参与研究调查了亚特兰大黑人和白人男男性接触者之间的艾滋病毒差异。在没有报告自己是阳性的HIV阳性参与者中，我们检查了其他意识指标：HIV病毒载量(VL) <1000拷贝/mL（低VL），血液中抗逆转录病毒（ARV）药物，以前的HIV病例监测报告。仅使用自我报告，32%（192人中62人）的黑人和16%（45人中7人）的白人MSM不知道自己感染了HIV （P = .03）。使用自我报告和低VL， 25%（192人中48人）黑人和16%（45人中7人）白人MSM缺乏意识（P = 0.18）。使用自我报告和抗逆转录病毒药物，26%（192人中50人）的黑人男男性接触者和16%（45人中7人）的白人男男性接触者缺乏意识（P = 0.14）。使用自我报告和监测报告，15%（192人中28人）的黑人和13%（45人中6人）的白人男男性行为者缺乏意识（P = 0.83）。自我报告可能高估了黑人男男性接触者对艾滋病毒状况真正缺乏认识的情况。如果，正如我们的数据所显示的那样，黑人男同性恋者比白人男同性恋者更不可能意识到他们感染了艾滋病毒，那么这个因素就不是艾滋病毒差异的主要驱动因素。今后依赖于对艾滋病毒状况认识的准确测量的艾滋病毒研究应考虑包括更多的实验室和病例监测数据。
Using only self-reported information likely overestimates lack of awareness of HIV status for black MSM. Estimates that also incorporate laboratory and case surveillance measures do not show significant racial disparity in lack of awareness of HIV status. Lack of human immunodeficiency virus (HIV) infection awareness may be a driver of racial disparities in HIV infection among men who have sex with men (MSM). Lack of awareness is typically measured by comparing HIV test result to self-reported HIV status. This measure may be subject to reporting bias and alternatives are needed. The InvolveMENt study examined HIV disparities between black and white MSM from Atlanta. Among HIV-positive participants who did not report knowing they were positive, we examined other measures of awareness: HIV viral load (VL) <1000 copies/mL (low VL), antiretroviral (ARV) drugs in blood, and previous HIV case surveillance report. Using self-report only, 32% (62 of 192) of black and 16% (7 of 45) of white MSM were not aware of their HIV infection (P = .03). Using self-report and low VL, 25% (48 of 192) black and 16% (7 of 45) white MSM lacked awareness (P = .18). Using self-report and ARVs, 26% (50 of 192) black and 16% (7 of 45) white MSM lacked awareness (P = .14). Using self-report and surveillance report, 15% (28 of 192) black and 13% (6 of 45) white MSM lacked awareness (P = .83). Self-report only may overestimate true lack of awareness of HIV status for black MSM. If, as our data suggest, black MSM are not less likely to be aware of their HIV infection than are white MSM, then this factor is not a substantial driver of HIV disparity. Future HIV research that depends on accurate measurement of HIV status awareness should consider including additional laboratory and case surveillance data.