Assessing HIV Risk and Prevention Locations among Men who have Sex with Men

 描述（由申请人提供）在美国，大多数HIV感染发生在男男性行为者（MSM）中。鉴于艾滋病毒新诊断病例数量仍然很高，以及种族和族裔之间的差异，必须更深入地了解新感染病例的背景，以便更好地利用现有资源，并制定新的预防办法。为了系统地研究基于场所和非个体风险因素的作用，必须系统地定义MSM从事特定行为的场所，并量化这些场所、特征和地理关系与特定HIV相关行为之间的关联。通过更好地定义行为发生的空间，基于地点的研究还可以帮助我们了解早期艾滋病毒诊断和治疗的结构性障碍以及风险行为的结构性决定因素。因此，对代表MSM日常生活的特定地点的检查可能有助于改进对艾滋病毒流行病学的理解，并有针对性地提供艾滋病毒预防和治疗资源。在此背景下，本研究将解决三个目标。首先，本研究将探讨男男性接触者的意愿，指定艾滋病毒预防和危险行为的位置，使用在线地图为基础的工具。先前的研究已经验证了一个在线的基于地图的工具，用于收集艾滋病毒阳性男男性行为者中的地理定位艾滋病毒护理地点。然而，更彻底地检查与风险和预防有关的地方需要更大的男男性行为者样本，包括艾滋病毒阴性和阳性，以及男男性行为者愿意报告有关广泛地点的信息。一个大样本的男男性行为者将使用这个在线工具，以提供与艾滋病毒的风险和预防相关的各种位置。回答这些问题的意愿与年龄，种族和其他健康和社会经济因素之间的关系将被探讨。其次，本研究将探讨男男性接触者的特定风险部位与预防行为。使用活动空间的概念，家庭和其他地点的距离和空间传播将被量化，这些地理分布和艾滋病毒的风险和预防行为之间的关联将被测量。此外，这些措施可能会有所不同的种族和城市化水平，提供潜在的信息种族和地理差异在艾滋病毒最后，本研究将探讨男男性接触者的迁移模式。使用从在线调查收集的数据，将使用生命过程流行病学方法来研究移民与艾滋病毒风险和预防行为之间的关系。这些方法允许同时探索风险和预防行为以及迁移的时间和数量之间的关联。鉴于我们的样本量较大，将观察到城市化和种族/民族之间的潜在差异。

 DESCRIPTION (provided by applicant In the United States, most HIV infections occur in men who have sex with men (MSM). Given the continued high numbers of new HIV diagnoses and differences by race and ethnicity, it is critical to develop a deeper understanding of the context of new infections in order to better target existing resources and to develop new prevention approaches. To examine the roles of place-based and non-individual risk factors systematically, the places where MSM engage in specific behaviors must be systematically defined, and associations between these locations, their characteristics and geographic relationships, and specific HIV-related behaviors must be quantified. By better defining the space in which behaviors occur, place-based studies can also aid in our understanding of structural barriers to early HIV diagnosis and treatment and of structural determinants of risk behaviors. Therefore, an examination of specific locations representing the everyday lives of MSM may be useful in refining the understanding of HIV epidemiology and in targeting HIV prevention and treatment resources. Within this context, this research will address three aims. First, this research will examine the willingness of MSM to specify locations of HIV prevention and risk behaviors using an online map-based tool. Prior studies have validated an online map-based tool for collection of geolocated HIV-care locations among HIV-positive MSM. However, more thoroughly examining places associated with risk and prevention requires a larger sample of MSM, both HIV-negative and HIV-positive, and a willingness of MSM to report information about a broad range of locations. A large sample of MSM will use this online tool to provide various locations associated with HIV risk and prevention. Relationships between a willingness to answer these questions and age, race, and other health and socioeconomic factors will be explored. Second, this research will examine specific locations of risk and prevention behaviors among MSM. Using the concept of activity space, the distance and spatial spread of home and other locations will be quantified, and associations between these geographic distributions and HIV risk and prevention behaviors will be measured. Additionally, these measures may differ by race and level of urbanicity, providing potential information about racial and geographic disparities in HIV Finally, this research will examine migration patterns of MSM. Using data collected from the online survey, life course epidemiologic methods will be used to examine relationships among migration, and HIV risk and prevention behaviors. These methods allow simultaneous exploration of associations between risk and prevention behaviors and both timing and amount of migration. Given our large sample size, potential differences across urbanicity and by race/ethnicity will be observed.