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系列复杂的因素，这些因素相互作用会对社会特定群体产生有害的健康结果。在美国，当前的人类免疫缺陷病毒 (HIV) 状况继续受到病例分布差异的影响，因为非洲裔美国人 (AA) 的新发艾滋病毒病例和艾滋病毒相关死亡人数比任何其他种族/族裔群体都多。重要的是，与男性发生性关系的年轻 AA 男性（MSM；年龄 13-29 岁）中新发艾滋病毒感染者 (52%) 比任何其他种族/族裔性取向/行为群体都要多。最近的研究发现，地理和邻里环境（广义上的环境包括物理和社会属性）与性行为和艾滋病毒流行和发病率有关。尽管地理和社区环境在艾滋病毒中可能发挥的作用经常被强调，但对环境因素的严格调查却很少。部分原因是艾滋病毒感染者居住地址信息的敏感性以及识别和描述相关社会和自然环境的困难。 HIV 地理和邻里研究 (GANSH) 的总体目标是检查地理空间和邻里环境特征与社会心理因素以及密西西比州杰克逊大都会统计区 (杰克逊 MSA) AA MSM 中流行的 HIV/STI 之间的关联。拟议的研究采用横断面、多层次的设计来检验这些关联。将使用具有随机邻域截距和随机协变量效应的多级模型来检查地理和邻里特征与 HIV/STI 状态测量之间的非线性（即二分结果变量）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特定地区艾滋病毒的相对风险以及行为和心理社会因素与艾滋病毒/性传播感染状况之间关联的空间分布。 据我们所知，这是第一项研究 AA MSM 中地理空间和邻里特征与心理社会因素和流行的 HIV/STI 之间关系的研究。拟议的研究将为一系列具有公共卫生重要性的问题提供答案，对疾病预防产生直接影响。此外，拟议研究的结果可能会改变现有艾滋病毒/性传播感染干预和/或预防研究的方法/理论概念。 公共卫生相关性：艾滋病毒/性传播感染研究传统上侧重于个人层面的风险因素，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影响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、社区和社会层面因素之间复杂的相互作用，并允许在研究过程中考虑多个层面的因素。个人经历或增加艾滋病毒/性传播感染风险的风险。这项研究的结果将为了解 AA MSM 中的 HIV/STI 风险以及确定疾病预防目标的高风险区域提供重要信息。