Des Jarlais Don C, Arasteh Kamyar, McKnight Courtney, Feelemyer Jonathan, Tross Susan, Perlman David, Friedman Samuel, Campbell Aimee
Don C. Des Jarlais, Kamyar Arasteh, Courtney McKnight, Jonathan Feelemyer, and David Perlman are with Icahn School of Medicine at Mount Sinai, New York, NY. Susan Tross and Aimee Campbell are with Department of Psychiatry, Columbia University, New York. Samuel Friedman is with National Research and Development Institutes, New York.
Am J Public Health. 2017 Jul;107(7):1157-1163. doi: 10.2105/AJPH.2017.303787. Epub 2017 May 18.
To examine whether racial/ethnic disparities persist at the "end of the HIV epidemic" (prevalence of untreated HIV infection < 5%; HIV incidence < 0.5 per 100 person-years) among persons who inject drugs (PWID) in New York City.
We recruited 2404 PWID entering New York City substance use treatment in 2001 to 2005 and 2011 to 2015. We conducted a structured interview, and testing for HIV and herpes simplex virus 2 (HSV-2; a biomarker for high sexual risk). We estimated incidence by using newly diagnosed cases of HIV. Disparity analyses compared HIV, untreated HIV, HIV-HSV-2 coinfection, HIV monoinfection, and estimated HIV incidence among Whites, African Americans, and Latinos.
By 2011 to 2015, Whites, African Americans, and Latino/as met both criteria of our operational "end-of-the-epidemic" definition. All comparisons that included HIV-HSV-2-coinfected persons had statistically significant higher rates of HIV among racial/ethnic minorities. No comparisons limited to HIV monoinfected persons were significant.
"End-of-the-epidemic" criteria were met among White, African American, and Latino/a PWID in New York City, but elimination of disparities may require a greater focus on PWID with high sexual risk.
研究在纽约市注射毒品者（PWID）中，种族/族裔差异在“艾滋病流行末期”（未治疗的艾滋病毒感染患病率<5%；艾滋病毒发病率<每100人年0.5例）是否仍然存在。
我们招募了2001年至2005年以及2011年至2015年进入纽约市物质使用治疗机构的2404名注射毒品者。我们进行了结构化访谈，并对艾滋病毒和单纯疱疹病毒2（HSV-2；高性风险生物标志物）进行检测。我们通过新诊断的艾滋病毒病例估计发病率。差异分析比较了白人、非裔美国人和拉丁裔之间的艾滋病毒、未治疗的艾滋病毒、艾滋病毒-HSV-2合并感染、艾滋病毒单一感染以及估计的艾滋病毒发病率。
到2011年至2015年，白人、非裔美国人和拉丁裔均符合我们操作性“流行末期”定义的两个标准。所有纳入艾滋病毒-HSV-2合并感染人群的比较中，种族/族裔少数群体的艾滋病毒感染率在统计学上显著更高。没有仅限于艾滋病毒单一感染人群的比较具有显著性。
纽约市的白人、非裔美国人和拉丁裔注射毒品者达到了“流行末期”标准，但要消除差异可能需要更关注高性风险的注射毒品者。
