在预防艾滋病方面量化结构性劣势:美国艾滋病特异性社会和结构性决定因素指数的开发和验证
Chen Zhang1, Yao Tang2, Wonkyung Kniffen1
1School of Nursing, University of Rochester, Rochester, New York, USA.
AIDS patient care and STDs
|September 5, 2025
概括
一个新的指数 - - 艾滋病特异性社会和结构性健康决定因素指数 (HIV-SSDI) 量化了影响艾滋病护理的结构性劣势. 较高的分数与艾滋病毒的流行率和预防工具的使用相关,
科学领域:
- 公共卫生
- 流行病学
- 医疗公平
背景情况:
- 结构上的不平等在艾滋病毒治疗连续性的差异上有很大影响.
- 衡量美国人口艾滋病特异性结构脆弱性的有效工具有限.
研究的目的:
- 引入和验证艾滋病特异性社会和结构性健康决定因素指数 (HIV-SSDI) 作为国家一级的指标.
- 评估艾滋病毒SSDI与关键艾滋病毒治疗连续结果的关联.
主要方法:
- 在9个结构领域使用公开可用的州级数据 (2008-2023) 开发了HIV-SSDI.
- 使用探索性因子分析 (主要成分分析,最大概率,最小剩余) 来构建指数.
- 使用截面和纵向线性回归模型评估与艾滋病毒治疗连续结果的关联.
主要成果:
- 三个潜伏的因素出现:社会经济/医疗服务的劣势,艾滋病毒服务基础设施/城市密度以及结构/法律背景.
- 较高的HIV-SSDI得分与艾滋病毒流行率,死亡率,暴露前预防 (PrEP) 使用率和检测率的增加有关.
- 纵向分析显示,与诊断率的相关性下降,但随着时间的推移与PrEP使用和PrEP与需求比率的相关性增加.
结论:
- 艾滋病毒SSDI是一个验证的,多维的衡量标准,用于评估与艾滋病毒相关的结构性劣势.
- 该指数与预防结果的不断变化的关联凸显了其对政策和资源分配的有用性.
- 艾滋病毒-SSDI可以指导识别高需要的国家,并监测与艾滋病毒相关的健康公平的进展.
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