PS11-003 Minority AIDS Research Initiative

项目摘要/摘要 健康差距的病因涉及一个复杂的因素网络，这些因素相互作用，从而产生 对特定社会阶层的有害健康后果。在美国，目前的 人类免疫缺陷病毒(HIV)的格局继续受到病例差异的影响 分布，因为非洲裔美国人(AA)占更多的新艾滋病毒病例和艾滋病毒相关死亡 比任何其他种族/民族都要多。重要的是，有更多的新的艾滋病毒感染(52%) 在与男性(MSM；13-29岁)发生性行为的年轻AA男性中， 种族/民族-性取向/行为群体。最近的研究发现，地理位置 和邻里环境(环境被广泛理解为包括两者 身体和社会属性)与性行为和艾滋病毒流行有关 发病率。尽管地理和邻里环境在艾滋病毒中的可能作用通常 尽管如此，对环境因素进行严格的调查却很少见。这在一定程度上是因为， 爱滋病毒感染者住址资料的敏感性质及困难 在确定和描述相关的社会和自然环境方面。 艾滋病毒地理和邻里研究(GANSH)的总体目标是 检查地理空间和邻近环境特征之间的关联 密西西比州杰克逊市AA男男性接触者的心理社会因素和HIV/STI流行情况 大都会统计区(杰克逊MSA)。这项拟议的研究使用了横断面、多层次的 水平设计来检查这些关联。非线性(即二分法的结果变量) HIV/STI的地理和社区特征与防治措施的关系 将使用具有随机邻域截距的多级模型和 随机协变量效应。经验贝叶斯与地理信息系统(GIS)方法 将用于估计和绘制特定地区艾滋病毒的相对风险以及空间 行为和心理社会因素与HIV/STI状态之间关系的分布。 据我们所知，这是第一次研究地理空间与 AA男男性接触者的社区特征、心理社会因素及HIV/STI流行情况。 拟议的研究将为广泛的公共卫生问题提供答案。 对疾病预防具有直接影响的重要性。此外，建议的 这项研究可能会改变现有艾滋病毒/性传播感染干预的方法/理论概念 和/或预防研究。

Project Summary/Abstract The etiology of health disparities involves a complex web of factors that interact to produce detrimental health outcomes for particular segments of society. In the United States, the current landscape of human immunodeficiency virus (HIV) continues to be shaped by disparities in case distribution, as African Americans (AA) account for more new HIV cases and HIV related deaths than any other racial/ethnic group. Importantly, there were more new HIV infections (52%) among young AA men who have sex with men (MSM; aged 13-29 years) than any other racial/ethnic-sexual orientation/behavior group. Recent studies have found that geographical and neighborhood environments (with environment broadly understood to encompass both physical and social attributes) are associated with sexual behavior and HIV prevalence and incidence. Although the possible role of geographic and neighborhood contexts in HIV has often been emphasized, rigorous investigations of environmental factors are rare. This is due, in part, to the sensitive nature of residential address information of HIV-infected persons and difficulties in identifying and characterizing the relevant social and physical environments. The overall aim of the Geographic and Neighborhood Study of HIV (GANSH) is to examine the associations between geospatial and neighborhood environmental characteristics and psychosocial factors and prevalent HIV/STI among AA MSM in the Jackson, MS metropolitan statistical area (Jackson MSA). The proposed study uses a cross-sectional, multi- level design to examine these associations. Non-linear (i.e., a dichotomized outcome variables) relationships between geographic and neighborhood characteristics and measures of HIV/STI status will be examined using multi-level models with a random neighborhood intercept and random covariate effects. Empirical Bayes and Geographic Information Systems (GIS) methods will be used to estimate and map the area-specific relative risk of HIV as well as the spatial distribution of the associations between behavioral and psychosocial factors and HIV/STI status. To our knowledge, this is the first study to examine the associations between geospatial and neighborhood characteristics and psychosocial factors and prevalent HIV/STI in AA MSM. The proposed research will provide answers to a wide range of questions of public health importance with direct implications for disease prevention. Moreover, results from the proposed study may change the methodological/theoretical concepts of existing HIV/STI interventions and/or prevention research.