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133rd Annual Meeting & Exposition
December 10-14, 2005
Larry M. Gant, CSW, PhD, School of Social Work, University of Michigan, 1080 S. University, Ann Arbor, MI 48109, 734-763-5990, Lmgant@umich.edu
Background: Human sex ratios (number of males/number of females) have explained male violence and dating behavior. Many studies report empirical associations between infrahuman sex behavior and sex ratios. Studies of human sex ratio and risky sexual behaviors are largely anecdotal. We use sex ratios to explain increases in African-American heterosexual HIV infection rates. We compare this analysis with other hypotheses used to explain increased HIV infection (e.g. employment rates, education; STD rates, and ‘downlow' infection by MSMs).
Methods: State and metropolitan area sex ratios of available African-American single heterosexual males to available African-American single heterosexual females were determined using US census data. Data estimates of African American MSMs were obtained, as were African-American reports of employment, education and STD rates. Reported cases of HIV among African-American women were obtained using state surveillance statistics. Data were converted to rates per 100,000 and log-transformed. Spatial clustering statistics using global (Besag/Newell's r, Moran's I) and local (Besag/Newell's I, local Moran) clusters complemented HLMs using alternative models (employment, STI, MSM).
Results: We found significant spatial effects between sex ratios and HIV cases for African-Americans. The distributions also provide parsimonious explanation for documented but unexplained patterns of regional distributions of HIV cases. Spatial maps illustrate the phenomenon. Analyses of HIV cases using alternative models were less powerful.
Conclusions: Sex ratios are empricially and substantively contextual factors explaining persistence of HIV among African-Americans. These structural components should inform future HERR interventions. Other explanations of HIV rates, while topical, may misinform and distract development of new interventions.
Keywords: HIV Interventions, HIV Risk Behavior
Presenting author's disclosure statement:
I wish to disclose that I have NO financial interests or other relationship with the manufactures of commercial products, suppliers of commercial services or commercial supporters.
The 133rd Annual Meeting & Exposition (December 10-14, 2005) of APHA