Do metropolitan HIV epidemic histories and programs for people who inject drugs and men who have sex with men predict AIDS incidence and mortality among heterosexuals?

Do metropolitan HIV epidemic histories and programs for people who inject drugs and men who have sex with men predict AIDS incidence and mortality among heterosexuals?
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大都会艾滋病毒的流行历史和计划是否注射与男人发生性关系的人预测异性恋者的发生率和死亡率?

DOI:
10.1016/j.annepidem.2014.01.008
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发表时间:
2014-04
影响因子:
5.6
通讯作者:
Cooper, Hannah L. F.
Cooper, Hannah L. F.
中科院分区:
医学3区
文献类型:
--
作者:
Friedman, Samuel R.;West, Brooke S.;Tempalski, Barbara;Morton, Cory M.;Cleland, Charles M.;Des Jarlais, Don C.;Hall, H. Irene;Cooper, Hannah L. F.

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我们专注于一个很少研究的问题--大都市地区关键人群中的艾滋病毒流行和项目如何影响其他关键人群的流行病。我们考虑:1)注射吸毒者(PWID)和男男性行为者(MSM)的早期流行与异性恋人群中后来的艾滋病发病率和死亡率有何关系?2)针对PWID或MSM的预防计划是否与异性恋人群中较低的艾滋病发病率和死亡率相关?以及3)大都市地区非注射吸毒者(NIDU)潜在桥梁人口的规模与异性恋人群中较晚的艾滋病发病率和死亡率是否相关?使用美国96个大城市地区的数据,泊松回归评估了以下因素之间的关系:感染HIV的PWID和MSM的人口流行率(1992);NIDU人群的流行率(1992-1994);PWID的药物使用治疗覆盖率(1993);MSM和PWID的HIV咨询和检测覆盖率(1992);以及注射器交换存在(2000)与美国疾病控制与预防中心2006-2008年异性恋者中艾滋病发病率和死亡率的数据进行了适当的社会经济控制。HIV+PWID和死点的人口密度与异性恋者的艾滋病晚期发病率和异性恋者的晚期死亡率呈正相关,而PWID的预防方案与异性恋者的晚期发病率和死亡率呈负相关。HIV+MSM的人口密度和MSM的预防计划与这些结果无关。努力减少艾滋病毒在PWID和死因人群中的传播可能会降低异性恋者中的艾滋病和艾滋病相关死亡率。需要在大都市地区、网络和个人层面进行更多的研究,探讨艾滋病毒在关键人群之间的联系,以及对一个关键人群的干预如何影响其他关键人群的艾滋病毒流行。
We focus on a little-researched issue—how HIV epidemics and programs in key populations in metropolitan areas affect epidemics in other key populations. We consider: 1) How are earlier epidemics among people who inject drugs (PWID) and men who have sex with men (MSM) related to later AIDS incidence and mortality among heterosexuals?; 2) Were prevention programs targeting PWID or MSM associated with lower AIDS incidence and mortality among heterosexuals?; and 3) Was the size of the potential bridge population of non-injecting drug users (NIDUs) in a metropolitan area associated with later AIDS incidence and mortality among heterosexuals? Using data for 96 large US metropolitan areas, Poisson regression assessed associations of population prevalences of HIV-infected PWID and MSM (1992); NIDU population prevalence (1992–1994); drug use treatment coverage for PWID (1993); HIV counseling and testing coverage for MSM and for PWID (1992); and syringe exchange presence (2000) with CDC data on AIDS incidence and mortality among heterosexuals in 2006 – 2008, with appropriate socioeconomic controls. Population density of HIV+ PWID and of NIDUs were positively related, and prevention programs for PWID negatively related, to later AIDS incidence among heterosexuals and later mortality among heterosexuals living with AIDS. HIV+ MSM population density and prevention programs for MSM were not associated with these outcomes. Efforts to reduce HIV transmission among PWID and NIDUs may reduce AIDS and AIDS-related mortality among heterosexuals. More research is needed at metropolitan area, network and individual levels into HIV bridging across key populations and how interventions in one key population affect HIV epidemics in other key populations.
DOI: 10.1097/olq.0b013e3181e1a64a
发表时间: 2010-10
影响因子: 3.1
作者:
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DOI: 10.1371/journal.pone.0031227
发表时间: 2012
期刊: PloS one
影响因子: 3.7
作者:
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DOI: 10.1109/tac.1974.1100705
发表时间: 1974-01-01
影响因子: 6.8
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DOI: 10.1016/j.amepre.2009.06.020
发表时间: 2009-11-01
影响因子: 5.5
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发表时间: 1998-01-01
影响因子: 2
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