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This study used the PPOR model to categorize fetal and infant deaths in New York City, describe racial/ethnic disparities and guide interventions. During 1996-2000, the average feto-infant mortality rate was 11.5/1,000 live births plus fetal deaths for the city. Statistically significant racial/ethnic differences in feto-infant mortality were found with black non-Hispanic women experiencing a much higher rate of feto-infant mortality compared to other groups.
In New York City from 1996-2000, there were 3,443 fetal deaths (>20 weeks’ gestation), 574,476 live births and 3,188 deceased infants >500 g and were born to city residents. The feto-infant mortality rate among this population was 11.5/1,000 live births plus fetal deaths (Figure 1). Maternal health and prematurity was the largest contributing area to feto-infant mortality (5.9/1,000) followed by maternal care (3.0/1,000), infant health (1.4/1,000) and newborn care (1.2/1,000).
The PPOR model was applied to fetal and infant mortality data collected in New York City from 1996 to 2000. In accordance with the model, birthweight was imputed from gestational age where weight was missing, as described in the cited reference. Imputation was needed for 7.7% of spontaneous abortion records, 1.5% of infant death records and <1% of birth records.
INTRODUCTION
Consistent with the decline seen in the early 1990s, the infant mortality rate in New York City continued to decrease over the past five years from 7.8/1,000 live births in 1996 to 6.7/1,000 in 2000, exceeding the Healthy People 2000 objective of 7.0 but still higher than the Healthy People 2010 objective of 4.5/1,000. The fetal death rate also declined during this period from 12.6/1,000 live births plus fetal deaths >20 weeks’ gestation in 1996 to 10.8/ 1,000 in 2000. However, despite the declines in infant mortality, racial/ethnic disparities persist, with the infant mortality rate and fetal death rate for black non-Hispanic women much higher than the rate for white non-Hispanic women.
Focusing “Down Low”: Bisexual Black Men, HIV Risk and Heterosexual Transmission: DISCUSSION
5 Nov2009
This literature review adds key points to the dialogue about men on the down-low. First, black MSM are more likely than MSM of other races and ethnicities to identify as bisexual and to be bisexually active. Second, heterosexual identity and corresponding sexual behavior among black men are sometimes incon-gruent, but this discordance is not exclusive to nor greatest among black men. Third, black MSM are less likely than other MSM to disclose their homosexual behavior or identity, but nondisclosing black MSM may engage in fewer sexual risks with male sex partners than disclosing black MSM. Last, a large multi-site study found that more gay- or bisexually identified HIV-positive black MSM reported sex with women than heterosexually identified HIV-positive black MSM.
- In: HIV
- Tags: African American, black, down-low, HIV/AIDS
Focusing “Down Low”: Bisexual Black Men, HIV Risk and Heterosexual Transmission: RESULTS part 2
4 Nov2009
Nondisclosure of Homosexual Behavior or Bisexual Identity
Disclosure of homosexual identity or behavior among black MSM was addressed in five articles and one conference abstract. A Chicago-based sample of 208 black and 142 white bisexually active men found that, compared with white MSM, black MSM were significantly more likely to keep their same-sex behavior from their female partners (75% and 36%, respectively). Similarly, a Virginia-based study of 523 MSM found that white men were significantly more likely than black men to disclose their bisexual or gay identity to family (62% versus 46%), heterosexual friends (59% versus 35%), healthcare providers (48% versus 29%), church members (32% versus 12%) and other groups of people. Moreover, as education level increased, white men were more likely and black men substantially less likely to disclose their sexuality. In contrast, a study in Los Angeles, which enrolled primarily gay or bisexual HIV-positive MSM, found no racial differences in disclosure of sexual orientation to lovers or parents but found modest racial differences in disclosure of HIV (Drug Viramune treating HIV infection) status to lovers.
- In: HIV
- Tags: African American, black, down-low, HIV/AIDS
Prevalence of Bisexuality among Black Men
Studies clearly show that black MSM are more likely than MSM of other races and ethnicities to identify themselves as bisexual and to be bisexually active.101217 Most studies that recruited black bisexual men assessed bisexuality according to self-reported behavior rather than self-identifica-tion. Among black MSM in 18 studies, from 2% to 71% reported bisexual behavior, and from 11% to 40% self-identified as bisexual. These estimates varied based upon whether studies recruited only MSM or a general population of men. Time periods during which bisexual behavior was assessed varied from proximal estimates (e.g., past three months, six months or a year), to extended periods of time (e.g., five years, since 1977, lifetime). Others did not specify a time period. In two studies that provided estimates for both recent and historical bisexual behavior, the prevalence of bisexual behavior was higher when evaluated over a longer (>5 years) period of time than a shorter (within the past year) timeframe.
- In: HIV
- Tags: African American, black, down-low, HIV/AIDS