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Will "combined prevention" eliminate racial/ethnic disparities in HIV infection among persons who inject drugs in New York City?

TitleWill "combined prevention" eliminate racial/ethnic disparities in HIV infection among persons who inject drugs in New York City?
Publication TypeJournal Article
Year of Publication2015
AuthorsDes Jarlais, DC, Arasteh, K, McKnight, C, Feelemyer, J, Hagan, H, Cooper, H, Campbell, A, Tross, S, Perlman, D
JournalPLoS One
Volume10
Issue5
Paginatione0126180
ISSN1932-6203
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.

DOI10.1371/journal.pone.0126180
Alternate JournalPLoS ONE
PubMed ID25965957
PubMed Central IDPMC4428770
Grant ListP30 DA011041 / DA / NIDA NIH HHS / United States