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首页> 美国卫生研究院文献>Bulletin of the New York Academy of Medicine >Risky Trade: Individual and Neighborhood-Level Socio-Demographics Associated with Transactional Sex among Urban African American MSM
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Risky Trade: Individual and Neighborhood-Level Socio-Demographics Associated with Transactional Sex among Urban African American MSM

机译：风险交易：城市非裔美国人MSM中与交易性相关的个人和邻里级社会人口统计学

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There is a clear, persistent association between poverty and HIV risk and HIV infection. Low educational attainment, neighborhood disadvantage, and residential instability are ways in which poverty is instrumentally experienced in urban America. We investigated the role of lived poverty at both the individual and neighborhood levels in transactional sex behavior among African American men who have sex with men (MSM) residing in urban neighborhoods. Using population-averaged models estimated by generalized estimating equation (GEE) models, we identified individual-level and neighborhood-level factors that are associated with exchanging sex for drugs and/or money. We tested the association between neighborhood and individual-level socioeconomic status and HIV risk behavior by combining area-based measures of neighborhood quality from the US Census with individual survey data from 542 low-income African American MSM. The primary outcome measure was self-reported transactional sex defined as exchanging sex for drugs or money. Individual-level covariates included high school non-completion, income, and problem drug use. Neighborhood-level covariates were high school non-completion and poverty rates. The findings suggested that educational attainment is associated with both the individual level and neighborhood level. Participants were more likely to engage in transactional sex if they did not complete high school (OR = 1.78), and similarly if their neighbors did not complete high school (OR = 7.70). These findings suggest potential leverage points for both community-level interventions and advocacy for this population, particularly related to transactional sex and education, and will aid HIV prevention efforts that seek to address the contextual constraints on individual risk behavior.
机译：贫困与艾滋病毒风险和艾滋病毒感染之间存在着明显的持续联系。受教育程度低，邻里不利和居住不稳定是美国城市贫困发生的工具。我们调查了居住在城市社区中与男性发生性关系（MSM）的非裔美国人中，生活贫困在个体和社区两级在交易性行为中的作用。使用由广义估计方程（GEE）模型估计的人口平均模型，我们确定了与性行为交换毒品和/或金钱相关的个人水平和邻里水平因素。我们通过结合美国人口普查中基于区域的邻里质量衡量标准和来自542个低收入非裔美国人MSM的个人调查数据，测试了邻里与个人级别的社会经济状况以及HIV风险行为之间的关联。主要结局指标是自我报告的交易性行为，定义为将性行为换成毒品或金钱。个体水平的协变量包括高中未完成，收入和毒品使用问题。邻里水平的协变量是高中毕业率和贫困率。研究结果表明，受教育程度与个人水平和邻里水平都有关系。如果参与者未完成高中学业（OR = 1.78），并且参加者的邻居未完成中学学业（OR = 7.70），则参加性交易的可能性更高。这些发现表明，针对该人群的社区干预和倡导活动都具有潜在的杠杆作用点，特别是与性交易和教育有关的艾滋病，并有助于艾滋病预防工作，以解决针对个人风险行为的背景限制。

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