1. Latent class analysis of a syndemic of risk factors on HIV testing among black men
- Author
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Typhanye Dyer, Natalie Slopen, Shuo Chen, Bradley O. Boekeloo, Rodman E. Turpin, and Cher M. Dallal
- Subjects
Adult ,Male ,Health (social science) ,Adolescent ,Social Psychology ,Human immunodeficiency virus (HIV) ,HIV Infections ,macromolecular substances ,Hiv testing ,medicine.disease_cause ,Health Services Accessibility ,Men who have sex with men ,Behavioral Risk Factor Surveillance System ,Young Adult ,03 medical and health sciences ,0302 clinical medicine ,Syndemic ,Risk Factors ,medicine ,Humans ,030212 general & internal medicine ,Heterosexuality ,Poverty ,030505 public health ,Depression ,business.industry ,Public Health, Environmental and Occupational Health ,AIDS Serodiagnosis ,Middle Aged ,Latent class model ,Black or African American ,Latent Class Analysis ,0305 other medical science ,business ,Demography - Abstract
Syndemic methodology has been employed in several studies of HIV-related outcomes affecting Black men who have sex with men (BMSM) and rarely in Black heterosexual men. In contrast to the most common method for assessing syndemics, the use of a syndemic component index, latent class analysis can identify unique combinations of risk factors that may form a syndemic. Analyzing a primarily heterosexual sample of 1,786 Black men from the 2015 Behavioral Risk Factor Surveillance System (BRFSS), we used a 4 latent class model based on depression diagnosis, poverty, and healthcare access to predict ever having been HIV tested. Class 1 was characterized by low proportions of all the risk factors. Class 2 had relatively high healthcare barriers, being the most likely to not have a personal doctor (.8175) and the most likely to have no routine checkup in the past year (.6327) but had relatively low depression diagnosis and poverty. Class 3 had relatively high poverty (.8853), but generally low barriers to healthcare access. Class 4 was characterized by high proportions of all the risk factors. Using log-binomial regression models, there was a significantly lower prevalence of ever having been HIV tested among class 3 (PR = 0.69, 95% CI 0.49, 0.98) and class 4 (PR = 0.49, 95% CI 0.28, 0.84) compared to class 1. When adjusting for education, age, and marital status, the associations were attenuated but still significant for class 3 (aPR = 0.71, 95% CI 0.52, 0.96) and class 4 (aPR = 0.60, 95% CI 0.46, 0.78). Latent class analysis may better serve syndemic research aims in understanding HIV-related outcomes among high-risk populations. Future research using this method to evaluate HIV testing outcomes among BMSM is recommended.
- Published
- 2018
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