Persistent racial/ethnic disparities in AIDS diagnosis rates among people who inject drugs in U.S. metropolitan areas, 1993-2007 (original) (raw)
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Racial/ethnic differences in the risk of AIDS in the United States
American Journal of Public Health, 1988
We analyzed the variation in the risk of AIDS in US Blacks, Hispanics, and other racial/ethnic groups relative to that in Whites (non-Hispanic) by geographic area and mode of acquiring HIV infection, based on data reported between
HIV/AIDS in Women and Racial/Ethnic Minorities in the U.S
Current infectious disease reports, 2012
The clinical issues affecting women with HIV/AIDS differ little from those affecting men. However, current research shows that treatment and outcome disparities affect many women with HIV, hypothesized to result from a complex interplay of socioeconomic and gender role influences. These disparities are also a reflection of racial/ethnic differences in treatment and outcome, since 80% of women with HIV/AIDS are black or Hispanic. Women have unique needs for HIV prevention - both prevention of sexual transmission to or from sexual partners and prevention of perinatal transmission. Racial/ethnic minorities continue to be disproportionately affected by the HIV/AIDS epidemic in the U.S. Minorities are less likely to be in care and on HAART than others with HIV/AIDS. These disparities result in poorer outcomes for minorities, especially blacks, with HIV/AIDS. New strategies for optimizing engagement and retention in care, and for prevention hold great promise for women and minorities with...
Annals of Epidemiology, 2015
Purpose-We estimated female and male incident AIDS diagnosis rates (IARs) among people who inject drugs (PWID) in US metropolitan statistical areas (MSAs) over time to assess whether declines in IARs varied by sex after combination antiretroviral therapy (cART) dissemination. Methods-We compared IARs and 95% confidence intervals (CIs) for female and male PWID in 95 of the most populous MSAs. To stabilize estimates we aggregated data across 3-year periods, selecting a period immediately preceding cART (1993-1995) and the most recent after the introduction of cART for which data were available (2005-2007). We assessed disparities by comparing IAR 95% CIs for overlap, female-to-male risk ratios, and disparity change scores. Results-IARs declined an average of 58% for female PWID and 67% for male PWID between the pre-cART and cART periods. Among female PWID, IARs were significantly lower in the later period relative to the pre-cART period in 48% of MSAs. Among male PWID, IARs were significantly lower over time in 86% of MSAs. Conclusions-IARs among female PWID in large US MSAs have declined more slowly than rates among male PWID. This suggests a need for increased targeting of prevention and treatment programs, and for research on MSA level conditions that may drive differences in declining AIDS rates among female and male PWID.
Comparison of HIV/AIDS rates between U.S.-born Blacks and African-born Blacks in Utah, 2000 - 2009
The open AIDS journal, 2012
The Utah Department of Health currently groups African-born blacks with U.S.-born blacks when reporting HIV/AIDS surveillance data. Studies suggest that categorizing HIV/AIDS cases in this manner may mask important epidemiological trends, and the distinct differences between these two populations warrant disaggregating data prior to reporting. The purpose of this study was to characterize the HIV/AIDS positive populations in U.S. and African-born blacks in Utah and evaluate the need for disaggregating the two groups. A total of 1,111 cases were identified through the statewide electronic HIV/AIDS Reporting System from 2000 - 2009. Data were analyzed for prevalence of HIV diagnosis for African-born blacks, U.S.-born blacks, and U.S.-born whites. Secondary analysis included HIV diagnosis by age, sex, African region of nativity, transmission risk factors, and differences in late diagnosis of HIV infection. U.S.-born whites accounted for 914 (82.3%) cases, and had the lowest annual prev...
We compared demographic variables of individuals in Miami-Dade County, Florida, USA, with Acquired Immune Deficiency Syndrome (AIDS) during two time periods (1993-1995 and 2009-2011). Incidence and mortality-related data were explored in this observational study. Tests of significance were performed to identify differences or associations between selected groups. A correlation analysis was conducted to identify relationships between AIDS diagnosis and socioeconomic indicators. We observed a reduction in the number of new AIDS cases reported and AIDS-related mortality. Nonetheless, AIDS is still disproportionately affecting the black non-Hispanic population. Black non-Hispanic women remain particularly vulnerable to the disease. A positive correlation between AIDS diagnosis and poverty rate and the lack of health insurance, and a negative correlation between AIDS diagnosis and education level were identified. Though the actual number of AIDS cases is declining in this region, it continues to disproportionately affect the poorer, less well
Annals of Epidemiology, 2015
Purpose-To describe factors associated with racial disparities in HIV incidence among men who have sex with men (MSM) in the United States. Methods-In a longitudinal cohort of black and white HIV-negative MSM in Atlanta, HIV incidence rates were compared by race. Incidence hazard ratios (HR) between black and white MSM were estimated with an age-scaled Cox proportional hazards model. A change-in-estimate approach was used to understand mediating time-independent and-dependent factors that accounted for the elevated HR. Results-Thirty-two incident HIV infections occurred among 260 black and 302 white MSM during 823 person-years (PY) of followup. HIV incidence was higher among black MSM (6.5/100PY; 95% CI: 4.2, 9.7) than white MSM (1.7/100PY; CI: 0.7, 3.3), and highest among young (18-24 years) black MSM (10.9/100PY; CI: 6.2, 17.6). The unadjusted hazard of HIV infection for black MSM was 2.9 (CI: 1.3-6.4) times that of white MSM; adjustment for health insurance status and partner race explained effectively all of the racial disparity. Conclusions-Relative to white MSM in Atlanta, black MSM, particularly young black MSM, experienced higher HIV incidence that was not attributable to individual risk behaviors. In a