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“联合预防”能否消除纽约市注射毒品者中艾滋病毒感染方面的种族/族裔差异?

Will "Combined Prevention" Eliminate Racial/Ethnic Disparities in HIV Infection among Persons Who Inject Drugs in New York City?

作者信息

Des Jarlais Don, Arasteh Kamyar, McKnight Courtney, Feelemyer Jonathan, Hagan Holly, Cooper Hannah, Campbell Aimee, Tross Susan, Perlman David

机构信息

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.

出版信息

PLoS One. 2015 May 12;10(5):e0126180. doi: 10.1371/journal.pone.0126180. eCollection 2015.


DOI:10.1371/journal.pone.0126180
PMID:25965957
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC4428770/
Abstract

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.

摘要

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)。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7b41/4428770/447f99a48632/pone.0126180.g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7b41/4428770/b3ce4ffbaeab/pone.0126180.g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7b41/4428770/447f99a48632/pone.0126180.g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7b41/4428770/b3ce4ffbaeab/pone.0126180.g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7b41/4428770/447f99a48632/pone.0126180.g002.jpg

相似文献

[1]
Will "Combined Prevention" Eliminate Racial/Ethnic Disparities in HIV Infection among Persons Who Inject Drugs in New York City?

PLoS One. 2015-5-12

[2]
Persistence and change in disparities in HIV infection among injection drug users in New York City after large-scale syringe exchange programs.

Am J Public Health. 2009-10

[3]
Racial/Ethnic Disparities at the End of an HIV Epidemic: Persons Who Inject Drugs in New York City, 2011-2015.

Am J Public Health. 2017-7

[4]
HIV infection among people who inject drugs: the challenge of racial/ethnic disparities.

Am Psychol. 2013

[5]
Racial Inequities in HIV Prevalence and Composition of Risk Networks Among People Who Inject Drugs in HIV Prevention Trial Network 037.

J Acquir Immune Defic Syndr. 2017-12-1

[6]
Similarities and differences by race/ethnicity in changes of HIV seroprevalence and related behaviors among drug injectors in New York City, 1991-1996.

J Acquir Immune Defic Syndr. 1999-9-1

[7]
Combined HIV prevention, the New York City condom distribution program, and the evolution of safer sex behavior among persons who inject drugs in New York City.

AIDS Behav. 2014-3

[8]
Racialized risk environments in a large sample of people who inject drugs in the United States.

Int J Drug Policy. 2016-1

[9]
Overview of HIV among injection drug users in New York City: critical next steps to eliminate racial/ethnic disparities.

Subst Use Misuse. 2011

[10]
Vital Signs: Trends in HIV Diagnoses, Risk Behaviors, and Prevention Among Persons Who Inject Drugs - United States.

MMWR Morb Mortal Wkly Rep. 2016-12-2

本文引用的文献

[1]
Use of the "NYC Condom" among people who use drugs.

J Urban Health. 2014-6

[2]
Combined HIV prevention, the New York City condom distribution program, and the evolution of safer sex behavior among persons who inject drugs in New York City.

AIDS Behav. 2014-3

[3]
HSV-2 Infection as a Cause of Female/Male and Racial/Ethnic Disparities in HIV Infection.

PLoS One. 2013-6-18

[4]
Is the HCV-HIV co-infection prevalence amongst injecting drug users a marker for the level of sexual and injection related HIV transmission?

Drug Alcohol Depend. 2013-2-28

[5]
Racial/ethnic disparities in HIV infection among people who inject drugs: an international systematic review and meta-analysis.

Addiction. 2012-10-18

[6]
Are females who inject drugs at higher risk for HIV infection than males who inject drugs: an international systematic review of high seroprevalence areas.

Drug Alcohol Depend. 2012-1-17

[7]
Persistence and change in disparities in HIV infection among injection drug users in New York City after large-scale syringe exchange programs.

Am J Public Health. 2009-10

[8]
Using hepatitis C virus and herpes simplex virus-2 to track HIV among injecting drug users in New York City.

Drug Alcohol Depend. 2009-4-1

[9]
Estimating sexual transmission of HIV from persons aware and unaware that they are infected with the virus in the USA.

AIDS. 2006-6-26

[10]
Do prevention interventions reduce HIV risk behaviours among people living with HIV? A meta-analytic review of controlled trials.

AIDS. 2006-1-9

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