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Corresponding Author: LaRon E. Nelson, School of Nursing, Yale University, 400 West Campus Drive, Orange, CT 06477, USA. Email: laron.nelson@yale.edu

The authors posthumously acknowledge Dr Robert Remis’s leadership in the development and implementation of this study.

The authors are also grateful to Jamie Thomas-Pavanel for managing the overall project and to Juan Liu for her support in managing the study data and to Anu Rebbapragada and Sanja Huibner for their expert performance of laboratory assays and management of laboratory-related logistics components for the study.

The authors wish to thank Women’s Health in Women’s Hands Community Health Centre, Rexdale Community Health Centre, and Taibu Community Health Centre for the support in conducting the study at their sites.

Finally, the authors express our sincere gratitude to the entire KALI Study team of recruiters and volunteer whose time and efforts led to the successful completion of this research project.

Declaration of Conflicting Interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

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Research Funding:

This publication/presentation/grant proposal was made possible through core services and support from the University of Rochester Center for AIDS Research (CFAR), an NIH-funded program (P30 AI078498) and the Yale Center for Interdisciplinary Research on AIDS (CIRA) an NIH-funded program (P30 MH062294).

This research was supported by Canadian Institute of Health Research grant #HET-85518, Ontario HIV Treatment Network (OHTN) Knowledge, Translation and Exchange grant and OHTN HIV Research Chair in Implementation Science with Black communities (AHRC#1066).

Keywords:

  • HIV
  • black men
  • risk
  • stigma
  • MSM
  • infection
  • testing
  • behavior
  • social economic status
  • care

Social, Clinical, and Behavioral Determinants of HIV Infection and HIV Testing among Black Men in Toronto, Ontario: A Classification and Regression Tree Analysis

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Journal Title:

Journal of the International Association of Providers of AIDS Care

Volume:

Volume 19

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Article | Final Publisher PDF

Abstract:

Black men bear a disproportionate burden of HIV infection. These HIV inequities are influenced by intersecting social, clinical, and behavioral factors. The purpose of this analysis was to determine the combinations of factors that were most predictive of HIV infection and HIV testing among black men in Toronto. Classification and regression tree analysis was applied to secondary data collected from black men (N = 460) in Toronto, 82% of whom only had sex with women and 18% whom had sex with men at least once. For HIV infection, 10 subgroups were identified and characterized by number of lifetime male partners, age, syphilis history, and perceived stigma. Number of lifetime male partners was the best single predictor of HIV infection. For HIV testing, the analysis identified 8 subgroups characterized by age, condom use, number of sex partners and Chlamydia history. Age (>24 years old) was the best single predictor of HIV testing.

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© The Author(s) 2020

This is an Open Access work distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International License (https://creativecommons.org/licenses/by-nc/4.0/).
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