Racial/ethnic disparities in HIV infection among people who inject drugs: an international systematic review and meta-analysis.
Racial/ethnic disparities in HIV infection among people who inject drugs: an international systematic review and meta-analysis.
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DOI：
10.1111/j.1360-0443.2012.04027.x
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发表时间：
2012-12
期刊：
影响因子：
--
通讯作者：
Hagan H
中科院分区：
文献类型：
--
作者：
Des Jarlais DC;Bramson HA;Wong C;Gostnell K;Cepeda J;Arasteh K;Hagan H
少数民族荟萃分析（EMMA）旨在评估不同国家注射吸毒者（PWID）中艾滋病毒感染的种族/民族差异。这是第一次报告的数据。采用标准系统综述/荟萃分析方法，包括检索、筛选和编码已发表和未发表的报告以及荟萃分析统计。我们遵循PRISMA声明和MOOSE指南的报告方法。用少数民族PWID与多数民族PWID之间艾滋病毒流行率的比值比来衡量差异;比值比> 1.0表示少数民族中的流行率较高。在131份流行率报告中审查了艾滋病毒感染者中的种族/族裔差异，其中214份种族/族裔少数与多数比较，包括106，715名艾滋病毒感染者。总体而言，合并OR表明，与种族/民族多数PWID相比，种族/民族少数人群中HIV患病率较高的可能性增加（OR=2.09，95% CI 1.92-2.28）。在214项比较中，106项比较对少数民族产生了统计学上显著较高的OR;在102项比较中，OR与1.0没有显著差异; 6项比较对多数群体成员产生了统计学上显著较高的OR。美国的差异尤其大，合并OR = 2.22（95% CI 2.03 - 2.44）。OR存在显著变化-I平方= 75.3%：IQR = 1.38 - 3.56-和对数OR的近似高斯分布。在注射毒品的人中，少数族裔艾滋病毒血清阳性的可能性大约是多数族裔的两倍。巨大的异质性和高斯分布表明有多种因果因素，需要根据当地条件采取干预措施。
The Ethnic Minority Meta-Analysis (EMMA) aims to assess racial/ethnic disparities in HIV infection among people who inject drugs (PWID) across various countries. This is the first report of the data. Standard systematic review/meta-analysis methods were utilized, including searching for, screening, and coding published and unpublished reports, and meta-analytic statistics. We followed the PRISMA Statement and MOOSE Guidelines for reporting methods. Disparities were measured with the odds ratio for HIV prevalence among ethnic minority PWID compared to ethnic majority PWID; an odds ratio> 1.0 indicated higher prevalence among ethnic minorities. Racial/ethnic disparities in HIV prevalence among PWID were examined in 131 prevalence reports, with 214 racial/ethnic minority to majority comparisons, comprising 106,715 PWID. Overall, the pooled OR indicates an increased likelihood of higher HIV prevalence among racial/ethnic minority compared to racial/ethnic majority PWID (OR=2.09, 95% CI 1.92-2.28). Among 214 comparisons, 106 produced a statistically significant higher OR for minorities; in 102 comparisons the OR was not significantly different from 1.0; six comparisons produced a statistically significant higher OR for majority group members. Disparities were particularly large in the US, pooled OR = 2.22 (95% CI 2.03 - 2.44). There was substantial variation in ORs—I squared = 75.3%: IQR = 1.38 - 3.56—and an approximate Gaussian distribution of the log ORs. Among people who inject drugs, ethnic minorities are approximately twice as likely to be HIV seropositive than ethnic majorities. The great heterogeneity and Gaussian distribution suggest multiple causal factors and a need to tailor interventions to local conditions.
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