Fanning T R, Cosler L E, Gallagher P, Chiarella J, Howell E M
New York State Department of Social Services, Albany 12243.
J Acquir Immune Defic Syndr (1988). 1991;4(10):1025-35.
An epidemiological analysis of the impact of AIDS on the New York and California Medicaid programs was conducted for 1983-1986. The epidemic affected the New York and California Medicaid programs in several similar ways. The total number of cases grew rapidly over the study time period. In both states, the epidemic was mostly confined to the young adult (21-44 years) age group. Cases were geographically concentrated and highly localized even within counties, but evidence of geographic dispersion to counties outside of the urban centers was also evident. Some dramatic differences were also found between California and New York. Patients with claims histories of drug use were far more likely to be found in the New York population and the proportion of other adult males (our proxy for the homosexual risk group) was higher in California. A much higher proportion of New York's population was female (30 vs. 5%). New York also had many more pediatric cases. Most importantly, New York's raw number of cases was substantially higher than California, with approximately three times as many cases during the time period (1983-1986). There is also substantial evidence that transmission of the disease to heterosexual partners of drug users places heterosexual urban minorities at grave risk of contracting the disease through interaction with infected persons.
针对1983年至1986年期间艾滋病对纽约和加利福尼亚医疗补助计划的影响进行了一项流行病学分析。这场流行病以几种相似的方式影响了纽约和加利福尼亚的医疗补助计划。在研究期间，病例总数迅速增长。在这两个州，疫情大多局限于年轻成年人（21至44岁）年龄组。病例在地理上集中，甚至在县内也高度局部化，但向城市中心以外的县扩散的证据也很明显。加利福尼亚和纽约之间也发现了一些显著差异。有吸毒索赔记录的患者在纽约人群中更为常见，而其他成年男性（我们用来代表同性恋风险群体的指标）在加利福尼亚的比例更高。纽约人口中女性的比例要高得多（30%对5%）。纽约的儿科病例也多得多。最重要的是，纽约的病例原始数量远高于加利福尼亚，在该时间段（1983年至1986年）内病例数大约是加利福尼亚的三倍。也有大量证据表明，疾病传播给吸毒者的异性恋伴侣，使城市异性恋少数群体通过与感染者接触而感染该疾病的风险极高。
