Examining inequities in rates of undiagnosed HIV and rectal STIs in a large nationwide cohort study of sexual minority men.
Examining inequities in rates of undiagnosed HIV and rectal STIs in a large nationwide cohort study of sexual minority men.
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DOI：
10.1136/sextrans-2021-055047
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发表时间：
2022-06
影响因子：
3.6
通讯作者：
中科院分区：
文献类型：
--
作者：
Sexual minority men (SMM) of colour are disproportionately impacted by HIV and bacterial STIs (bSTIs). To better understand within-group heterogeneity and differential risk factors by race and ethnicity, we sought to examine rates of undiagnosed HIV and rectal bSTI at the intersection of racial and ethnic identity with other sociodemographic factors. We examined data from 8105 SMM conducting home-based self-testing at enrolment in a nationwide cohort study collected from November 2017 to August 2018. We conducted analyses stratified by racial and ethnic groups to examine within-group (ie, subgroup) unadjusted rates of HIV and rectal bSTI infection across a range of characteristics. Rates of undiagnosed HIV were highest among Black (4.3%, n=39) and Latino (2.4%, n=38) SMM, with lower rates among those identified as multiracial (1.6%, n=15), white (1.3%, n=56) and other races (1.3%, n=6). Across the stratified analyses of HIV infection, 15 significant associations emerged showing that age, region, insurance type, sexual positioning and incarceration history had differential impacts across racial and ethnic groups. In particular, private and public insurance were protective against HIV for white but not Black and Latino SMM, and incarceration was associated with substantially higher rates of HIV infection for Black and Latino SMM relative to white SMM. We found significant co-occurrence of HIV and bSTI rates for participants who identified as Latino (OR=7.5, 95% CI 2.12 to 26.54), white (OR=3.19, 95% CI 1.14 to 8.98) and multiracial (OR=5.5, 95% CI 1.08 to 27.90), but not those who identified as Black (OR=0.82, 95% CI 0.10 to 6.56) or other races (OR=3.56 95% CI 0.31 to 40.80). Stratified analyses showed differential rates of HIV infection at the intersection of racial and ethnic groups with other characteristics, particularly insurance status and incarceration history, pointing to structural inequities rather than individual behaviours underlying disproportionately high rates of HIV for Black and Latino SMM.
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影响因子：
3.7
作者：
Scott HM;Irvin R;Wilton L;Van Tieu H;Watson C;Magnus M;Chen I;Gaydos C;Hussen SA;Mannheimer S;Mayer K;Hessol NA;Buchbinder S
通讯作者：
Buchbinder S
影响因子：
2.3
作者：
Kaplan KC;Hormes JM;Wallace M;Rountree M;Theall KP
通讯作者：
Theall KP
影响因子：
7.4
作者：
Rendina HJ;Mustanski B
通讯作者：
Mustanski B
影响因子：
1.7
作者：
Guo Y;Li X;Fang X;Lin X;Song Y;Jiang S;Stanton B
通讯作者：
Stanton B
影响因子：
4.4
作者：
Phillips, Tamsin;Brittain, Kirsty;Mellins, Claude A.;Zerbe, Allison;Remien, Robert H.;Abrams, Elaine J.;Myer, Landon;Wilson, Ira B.
通讯作者：
Wilson, Ira B.