Des Jarlais Don, Arasteh Kamyar, McKnight Courtney, Feelemyer Jonathan, Hagan Holly, Cooper Hannah, Campbell Aimee, Tross Susan, Perlman David
The Baron Edmond de Rothschild Chemical Dependency Institute, Mount Sinai Beth Israel, New York, New York, United States of America.
College of Nursing, New York University, New York, New York, United States of America.
PLoS One. 2015 May 12;10(5):e0126180. doi: 10.1371/journal.pone.0126180. eCollection 2015.
It has not been determined whether implementation of combined prevention programming for persons who inject drugs reduce racial/ethnic disparities in HIV infection. We examine racial/ethnic disparities in New York City among persons who inject drugs after implementation of the New York City Condom Social Marketing Program in 2007. Quantitative interviews and HIV testing were conducted among persons who inject drugs entering Mount Sinai Beth Israel drug treatment (2007-2014). 703 persons who inject drugs who began injecting after implementation of large-scale syringe exchange were included in the analyses. Factors independently associated with being HIV seropositive were identified and a published model was used to estimate HIV infections due to sexual transmission. Overall HIV prevalence was 4%; Whites 1%, African-Americans 17%, and Hispanics 4%. Adjusted odds ratios were 21.0 (95% CI 5.7, 77.5) for African-Americans to Whites and 4.5 (95% CI 1.3, 16.3) for Hispanics to Whites. There was an overall significant trend towards reduced HIV prevalence over time (adjusted odd ratio = 0.7 per year, 95% confidence interval (0.6-0.8). An estimated 75% or more of the HIV infections were due to sexual transmission. Racial/ethnic disparities among persons who inject drugs were not significantly different from previous disparities. Reducing these persistent disparities may require new interventions (treatment as prevention, pre-exposure prophylaxis) for all racial/ethnic groups.
针对注射毒品者实施联合预防方案是否能减少艾滋病毒感染方面的种族/族裔差异,目前尚未确定。我们研究了2007年纽约市实施避孕套社会营销方案后,纽约市注射毒品者中的种族/族裔差异。对进入西奈山贝斯以色列药物治疗中心的注射毒品者进行了定量访谈和艾滋病毒检测(2007 - 2014年)。分析纳入了703名在大规模注射器交换实施后开始注射毒品的人。确定了与艾滋病毒血清阳性独立相关的因素,并使用已发表的模型来估计性传播导致的艾滋病毒感染情况。总体艾滋病毒患病率为4%;白人1%,非裔美国人17%,西班牙裔4%。非裔美国人与白人的调整比值比为21.0(95%可信区间5.7,77.5),西班牙裔与白人的调整比值比为4.5(95%可信区间1.3,16.3)。随着时间推移,艾滋病毒总体患病率有显著下降趋势(调整后比值比 = 每年0.7,95%置信区间(0.6 - 0.8))。估计75%或更多的艾滋病毒感染是由性传播导致的。注射毒品者中的种族/族裔差异与之前的差异没有显著不同。减少这些持续存在的差异可能需要针对所有种族/族裔群体采取新的干预措施(治疗即预防、暴露前预防)。
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