PS11-003 Minority AIDS Research Initiative

PS11-003 少数民族艾滋病研究计划

• 批准号: 8212647
• 负责人: DEMARC A HICKSON
• 金额: $ 14.02万
• 依托单位: MY BROTHER'S KEEPER, INC.
• 依托单位国家: 美国
• 财政年份: 2012
• 资助国家: 美国
• 起止时间: 2012-01-01 至 2015-12-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8212647
• 关键词: PS11; 003; Minority; AIDS; Research

DESCRIPTION (provided by applicant): 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. PUBLIC HEALTH RELEVANCE: HIV/STI research has traditionally focused on individual-level risk factors such as behaviors, and more recently, socio-cultural factors. The conceptual framework for the Geographic and Neighborhood Effects on HIV Study is based on the socio-ecological model, which integrates the complex interaction between individual, relationship, community, and society-level factors and allows for the consideration of factors at multiple levels in an individual's risk for experiencing or increasing HIV/STI risk. Results from this study will provide critical information in the understanding of HIV/STI risk among AA MSM and identification of high-risk areas to target for disease prevention.

描述（由申请人提供）：健康差异的病因涉及一个复杂的因素网络，这些因素相互作用，以为社会特定领域产生有害的健康结果。在美国，当前人类免疫缺陷病毒（HIV）的景观在案例分布中继续受到差异的影响，因为非洲裔美国人（AA）对任何其他种族/种族群体的占据了新的HIV病例和HIV相关的死亡。重要的是，与男性发生性关系的年轻男性（MSM； 13-29岁）的新艾滋病毒感染（52％）要比任何其他种族/民族与性别方向/行为组。最近的研究发现，地理和邻里环境（环境广泛理解为涵盖身体和社会属性）与性行为以及艾滋病毒的流行和发病率有关。尽管经常强调地理和邻里环境在艾滋病毒中的可能作用，但对环境因素的严格研究很少。这部分归因于艾滋病毒感染者的住宅地址信息的敏感性以及在识别和表征相关的社会和身体环境方面的困难。 艾滋病毒（GANSH）地理和邻里研究的总体目的是检查地理空间和邻里环境特征与社会心理因素与心理社会因素与普遍的HIV/STI之间的关联。拟议的研究使用横截面多层设计来检查这些关联。非线性（即，二分法结果变量）将使用具有随机邻域截距和随机的协变量效应的多级模型来检查地理和邻里特征与艾滋病毒/STI状态之间的关系之间的关系。经验贝叶斯和地理信息系统（GIS）方法将用于估计和绘制艾滋病毒特定面积的相对风险以及行为和心理社会因素与艾滋病毒/STI状态之间关联的空间分布。 据我们所知，这是第一个研究地理空间和社区特征与心理社会因素与普遍的HIV/STI之间关联的研究。拟议的研究将为众多公共健康重要性问题提供答案，并直接对预防疾病产生影响。此外，拟议研究的结果可能会改变现有的HIV/STI干预和/或预防研究的方法论/理论概念。 公共卫生相关性：传统上，HIV/STI研究集中于个人级别的风险因素，例如行为以及最近的社会文化因素。地理和邻里对艾滋病毒研究的概念框架基于社会生态模型，该模型整合了个人，关系，社区和社会水平因素之间的复杂相互作用，并允许考虑个人在体验或增加HIV/STI风险风险中多个级别的因素。这项研究的结果将提供关键信息，以了解AA MSM之间对HIV/STI风险的理解，并确定高风险区域以预防疾病。