Persistent Racial/Ethnic Disparities in AIDS Diagnosis Rates Among People Who Inject Drugs in US Metropolitan Areas, 1993-2007
Persistent Racial/Ethnic Disparities in AIDS Diagnosis Rates Among People Who Inject Drugs in US Metropolitan Areas, 1993-2007
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DOI：
10.1177/003335491412900309
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发表时间：
2014-05-01
影响因子：
3.3
通讯作者：
Friedman, Samuel R.
中科院分区：
文献类型：
--
作者：
Pouget, Enrique R.;West, Brooke S.;Friedman, Samuel R.
目标。我们估计了美国大都市统计区 (MSA) 注射吸毒者 (PWID) 中不同种族/族裔的艾滋病诊断率 (IAR) 随着时间的推移，以评估高效抗逆转录病毒治疗 (HAART) 传播后差异的变化。方法。我们在 93 个人口最多的 MSA 中将黑人/非裔美国人和西班牙裔/拉丁裔注射吸毒者的 IAR 和 95% 置信区间 (CI) 与白人注射吸毒者的 IAR 和 95% 置信区间 (CI) 进行了比较。我们从HAART之前的年份（1993-1995）和具有最新可用数据的年份（2005-2007）中选择了两个三年期。为了最大限度地提高稳定性，我们汇总了三年期间的数据，并汇总了黑人/非裔美国人和西班牙裔/拉丁裔注射吸毒者的数据，以便与白人注射吸毒者的数据进行大多数比较。我们通过比较 IAR 95% CI 的重叠来评估差异。结果。 1993-1995 年 81% 的 MSA 和 2005-2007 年 77% 的 MSA 中，黑人/非裔美国人和西班牙裔/拉丁裔注射吸毒者的 IAR 显着高于白人注射吸毒者。随着时间的推移，差异变得不显着的多边地区集中在西方。黑人/非裔美国人和白人注射吸毒者（1993-1995 年占 MSA 的 85%，2005-2007 年占 MSA 的 79%）之间的比较比西班牙裔/拉丁裔和白人注射吸毒者（1993-1995 年占 MSA 的 53%，2005-2007 年占 MSA 的 56%）之间的比较更常见。在大多数 MSA 中，不同种族/族裔群体的 IAR 略有下降。结论。在大多数大型 MSA 中，黑人/非裔美国人和西班牙裔/拉丁裔注射吸毒者的艾滋病诊断率仍然大大高于白人注射吸毒者。这一发现表明需要加强预防和治疗计划的针对性，以及对可能有助于维持差异的 MSA 水平条件进行研究。
Objectives. We estimated race/ethnicity-specific incident AIDS diagnosis rates (IARs) among people who inject drugs (PWID) in U.S. metropolitan statistical areas (MSAs) over time to assess the change in disparities after highly active antiretroviral therapy (HAART) dissemination.Methods. We compared IARs and 95% confidence intervals (CIs) for black/African American and Hispanic/Latino PWID with those of white PWID in 93 of the most populous MSAs. We selected two three-year periods from the years immediately preceding HAART (1993-1995) and the years with the most recent available data (2005-2007). To maximize stability, we aggregated data across three-year periods, and we aggregated data for black/African American and Hispanic/Latino PWID for most comparisons with data for white PWID. We assessed disparities by comparing IAR 95% CIs for overlap.Results. IARs were significantly higher for black/African American and Hispanic/Latino PWID than for white PWID in 81% of MSAs in 1993-1995 and 77% of MSAs in 2005-2007. MSAs where disparities became non-significant over time were concentrated in the West. Significant differences were more frequent in comparisons between black/African American and white PWID (85% of MSAs in 1993-1995,79% of MSAs in 2005-2007) than in comparisons between Hispanic/Latino and white PWID (53% of MSAs in 1993-1995,56% of MSAs in 2005-2007). IARs declined modestly across racial/ethnic groups in most MSAs.Conclusions. AIDS diagnosis rates continue to be substantially higher for black/African American and Hispanic/Latino PWID than for white PWID in most large MSAs. This finding suggests a need for increased targeting of prevention and treatment programs, as well as research on MSA-level conditions that may serve to maintain the disparities.