HIV Infection in Ethnic Minority IDUs: An International Systematic Review

少数民族注射吸毒者中的艾滋病毒感染：国际系统评价

• 批准号: 7901007
• 负责人: Don C Des Jarlais
• 金额: $ 54.93万
• 依托单位: BETH ISRAEL MEDICAL CTR (NEW YORK)
• 依托单位国家: 美国
• 财政年份: 2008
• 资助国家: 美国
• 起止时间: 2008-08-01 至 2012-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7901007
• 关键词: AIDS prevention; AIDS/HIV problem; Accounting; Acquired Immunodeficiency Syndrome; Address; African American; Area; Arts; Asia; Australia; Categories; Code; Communities; Country; Data; Data Set; Developing Countries; Development; Disadvantaged; Discrimination; Drug usage; Drug user; Epidemic; Epidemiology; Ethnic group; Europe; Frequencies; Future; Geographic Locations; Glare; HIV; HIV Infections; Health Services Needs; Hepatitis C; Heterosexuals; Hispanics; Incidence; Individual; Injecting drug user; Injection of therapeutic agent; International; Intervention; Lead; Learning; Meta-Analysis; Methods; Minority Groups; Modeling; Morbidity - disease rate; North America; Pattern; Population; Prevalence; Procedures; Provider; Public Health; Publishing; Recommendation; Recording of previous events; Reporting; Research; Research Personnel; Risk; Risk Behaviors; Services; Sexual Partners; Sexual Transmission; Sexually Transmitted Diseases; Site; Stigmatization; Time; United States National Institutes of Health; caucasian American; ethnic difference; ethnic minority population; health disparity; innovation; member; mortality; non-drug; prevention service; public health relevance; racial and ethnic; racial/ethnic difference; repository; research study; sex risk; systematic review; transmission process; user-friendly

DESCRIPTION (provided by applicant): Racial/ethnic group disparities in HIV/AIDS are a critical public health issue in the US. These disparities are particularly dramatic with respect to injecting drug use. African-Americans constitute 13% of the US population and 52% of recent US injecting drug use AIDS cases; Hispanics constitute 14% of the US population and 24% of the injecting drug use AIDS cases. These disparities are not the result of more injecting drug users among African-Americans and Hispanics, but of higher rates of HIV infection among African- American and Hispanic IDUs in many areas of the country. Similar disparities-higher rates of HIV infection among ethnic minority IDUs-have also been observed in many foreign countries. Indeed the situation of ethnic minority IDUs in some developing countries can be considered a crisis, with extremely high incidence, prevalence and HIV-related mortality. Disparities have also been observed among non-injecting drug users, with ethnic minority group members having higher rates of HIV infection. The logical next step for addressing these disparities and this epidemiological conundrum is not another individual study, but a systematic review of the large number of relevant studies that have been conducted to date. Our proposed systematic review will use state-of-the-art methods and include the US and the international data on ethnic group differences in HIV infection among drug users. The specific aims include: Developing procedures for combining qualitative and quantitative data from multiple research studies of IDUs in a single geographic area into a "history of the HIV epidemic among IDUs" in that area. Determining the frequency of HIV epidemics in which substantial differences in HIV infection have and have not arisen in ethnic minority IDUs vs. ethnic majority IDUs in the US and internationally. Identifying potential causal factors that may generate substantial differences in HIV prevalence among racial/ethnic minority vs. ethnic majority IDUs. Identifying potential causal factors that may perpetuate or reduce differences in HIV infection among racial/ethnic differences over time. Identifying epidemiologic situations in which differences in HIV risk behaviors do or do not statistically "explain" differences in HIV infection among racial/ethnic groups of IDUs. The research will also create an extremely rich dataset on HIV infection among ethnic drug uses that will be made available for use by other researchers and HIV prevention service providers. The research addresses one of the most important aspects of HIV/AIDS-the frequent large disparities in HIV infection among ethnic groups in the US and in many other countries. The research will be an innovative application of state of the art methods for systematic review, including extensive searching for published and unpublished studies, quantitative coding of research reports, and applying meta-regression/hierarchical modeling to these problems. PUBLIC HEALTH RELEVANCE: Higher rates of HIV infection among African-American and Hispanic IDUs are a major health disparity in the US. African-Americans comprise 13% of the US population and 52% of injection drug use AIDS cases, Hispanics 14% of the populations and 24% of cases. Similar disparities, higher rates of HIV infection among ethnic minority IDUs, have also been observed in many foreign countries. An international systematic review and meta-analysis should greatly advance our understanding of these disparities and suggest how they might be ameliorated.

描述（由申请人提供）：艾滋病毒/艾滋病中的种族/族裔差异是美国的关键公共卫生问题。这些差异对于注射药物的使用尤其引人注目。非裔美国人占美国人口的13％，最近美国注射毒品使用艾滋病案件的52％；西班牙裔占美国人口的14％，注射毒品使用艾滋病案件的24％。这些差异并不是由于非裔美国人和西班牙裔在内的吸毒者更多地注入吸毒者的结果，而是该国许多地区非裔美国人和西班牙裔IDU的艾滋病毒感染率更高。在许多外国，也观察到少数民族iDus-Have中的艾滋病毒感染率更高。确实，一些发展中国家的少数民族IDU的处境可以被认为是危机，发病率极高，患病率和与HIV相关的死亡率极高。在非注射吸毒者中也观察到了差异，少数民族群体成员的艾滋病毒感染率较高。解决这些差异的逻辑下一步和这个流行病学的难题不是另一项个人研究，而是对迄今为止已经进行的大量相关研究的系统回顾。我们提出的系统审查将使用最先进的方法，其中包括美国和国际吸毒者艾滋病毒感染差异的国际数据。具体目的包括：开发从单个地理区域中IDU的多个研究研究中的定性和定量数据结合的程序，使该领域的“ IDU中的HIV流行历史”结合在一起。确定艾滋病毒流行病的频率，其中艾滋病毒感染的实质性差异已经在美国和国际上的少数族裔与族裔多数族裔IDU中产生并且没有产生。确定可能在种族/族裔少数族裔与族裔多数的艾滋病毒患病率上产生实质性差异的潜在因果因素。确定可能会随着时间的推移而导致种族/族裔差异之间的艾滋病毒感染差异或减少艾滋病毒感染的差异。确定艾滋病毒风险行为差异在IDU的种族/族裔群体之间在艾滋病毒感染中确实“解释”艾滋病毒感染差异的流行病学情况。这项研究还将在民族药物使用中创建一个非常丰富的艾滋病毒感染数据集，该数据集将被其他研究人员和艾滋病毒预防服务提供商使用。该研究涉及艾滋病毒/艾滋病最重要的方面之一 - 美国和许多其他国家的族裔群体之间频繁的艾滋病毒感染差异很大。这项研究将是对系统审查的艺术方法的创新应用，包括广泛搜索已发表和未发表的研究，研究报告的定量编码以及将元回归/分层模型应用于这些问题。 公共卫生相关性：非裔美国人和西班牙裔IDU的艾滋病毒感染率较高，在美国是主要健康差异。非裔美国人占美国人口的13％和52％的注射毒品艾滋病案件，西班牙裔人口的14％和24％的案件。在许多外国，也观察到类似的差距，较高的少数民族IDU的艾滋病毒感染率。国际系统的审查和荟萃分析应该大大提高我们对这些差异的理解，并暗示它们如何得到改善。