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首页> 外文期刊>Annals of epidemiology >Influence of residential segregation on survival after AIDS diagnosis among non-Hispanic blacks
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Influence of residential segregation on survival after AIDS diagnosis among non-Hispanic blacks

机译：非西班牙裔黑人居住区隔离对艾滋病诊断后存活的影响

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Purpose: Non-Hispanic blacks (NHBs) are disproportionately affected by the AIDS epidemic. With the advent of highly active antiretroviral therapy (HAART), survival after AIDS diagnosis has increased dramatically, yet survival among NHBs is shorter compared with non-Hispanic whites. Racial residential segregation may be an important factor influencing observed racial disparities in survival. Methods: We linked data on 30,813 NHBs from the Florida Department of Health HIV/AIDS Reporting system (1993-2004) with death records and applied segregation indices and poverty levels to the data. Weighted Cox models were used to examine the association between segregation measured on five dimensions and survival, controlling for demographic factors, clinical factors, and area-level poverty. Analyses were stratified by pre-HAART (1993-1995), early HAART (1996-1998), and late-HAART (1999-2004) eras. Results: In the late-HAART era, adjusting for area-level poverty, segregation remained a significant predictor of survival on two dimensions: Concentration (hazard ratio, 1.32; 95% confidence interval, 1.13-1.56) and centralization (hazard ratio, 1.44; 95% confidence interval, 1.12-1.84). Area-level poverty was an independent predictor of survival. Conclusions: These findings suggest that certain dimensions of segregation and poverty are associated with survival after AIDS diagnosis.
机译：目的：非西班牙裔黑人（NHBs）受艾滋病流行的影响尤其严重。随着高活性抗逆转录病毒疗法（HAART）的出现，艾滋病诊断后的存活率显着增加，但与非西班牙裔白人相比，NHB的存活期更短。种族居民隔离可能是影响观察到的种族差异生存的重要因素。方法：我们将佛罗里达州卫生部艾滋病报告系统（1993-2004年）的30,813个NHBs数据与死亡记录相关联，并对数据应用隔离指数和贫困水平。加权Cox模型用于检验在五个维度上测得的种族隔离与生存之间的关联，并控制人口统计学因素，临床因素和地区贫困水平。分析按HAART之前（1993-1995），HAART早期（1996-1998）和HAART晚期（1999-2004）时代进行了分层。结果：在HAART晚期，根据地区贫困状况进行调整，隔离仍然是两个方面生存的重要预测指标：集中度（危险比，1.32; 95％置信区间，1.13-1.56）和集中化（危险比，1.44） ; 95％置信区间1.12-1.84）。区域贫困是生存的独立预测指标。结论：这些发现表明，隔离和贫困的某些方面与艾滋病诊断后的生存有关。

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