Neighborhood-level associations with HIV infection among young men who have sex with men in Chicago.
Neighborhood-level associations with HIV infection among young men who have sex with men in Chicago.
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DOI：
10.1007/s10508-014-0459-z
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发表时间：
2015-10
影响因子：
3.8
通讯作者：
Mustanski B
中科院分区：
文献类型：
--
作者：
Phillips G 2nd;Birkett M;Kuhns L;Hatchel T;Garofalo R;Mustanski B
男男性行为青年（YMSM）中艾滋病毒感染率的上升是一个重大的公共卫生问题。传统的YMSM中的艾滋病毒研究主要集中在个人层面的预测因素，很少考虑背景或邻里层面的因素，如种族组成和社会经济地位。这项研究使用了来自美国人口普查和其他公共来源的社区水平数据，以及来自芝加哥YMSM纵向队列（Crew 450）的个人水平数据。在该队列中最初的450名YMSM中，有376名报告居住在芝加哥（83.6%），并被纳入分析样本。采用聚类方法，将77个社区按共同特征分组，从而确定了11个不同的聚类。个体HIV状态的无条件模型表明，相邻聚类之间存在显著的方差（χ2 = 21.66; p = 0.006）。当将个体水平变量加入模型中时，只有有HIV阳性性伴侣（OR = 6.41; CI：2.40，17.1）和在过去6个月内从事交换性行为（OR = 3.25; 95%CI：1.33，7.93）是HIV状态的显著预测因素。具有较高步行评分的集群不太可能包含HIV阳性个体（OR = 0.94; 95%CI：0.90，0.98）。相反，具有较大比例的空置建筑物的集群更有可能包含HIV阳性个体（OR = 1.19; 95%CI：1.07，1.33）。未来的研究YMSM需要调查的机制，居住区可能会影响从事危险行为或艾滋病毒的收购。
The rising incidence of HIV infection among young men who have sex with men (YMSM) is a substantial public health concern. Traditional research on HIV among YMSM has focused largely on individual-level predictors and infrequently accounts for contextual or neighborhood-level factors such as ethnic composition and socioeconomic status. This study used neighborhood-level data from the US Census and other public sources, and individual-level data from a longitudinal cohort of YMSM in Chicago (Crew 450). Of the original 450 YMSM in the cohort, 376 reported living in Chicago (83.6%) and were included in the analytic sample. A clustering approach was used to group the 77 community areas together by common characteristics, resulting in the identification of 11 distinct clusters. An unconditional model of individual HIV status indicated a significant amount of variance existed between neighborhood clusters (χ2 = 21.66; p = 0.006). When individual-level variables were added to the model, only having an HIV-positive sex partner (OR = 6.41; CI: 2.40, 17.1) and engaging in exchange sex in the past 6 months (OR = 3.25; 95% CI: 1.33, 7.93) were significant predictors of HIV status. Clusters with higher Walk Scores were less likely to contain HIV-positive individuals (OR = 0.94; 95% CI: 0.90, 0.98). Conversely, clusters with a larger proportion of vacant buildings were more likely to contain HIV-positive individuals (OR = 1.19; 95% CI: 1.07, 1.33). Future research among YMSM needs to investigate the mechanisms by which neighborhood of residence might influence engagement in risk behaviors or acquisition of HIV.