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

Full Abstract

OBJECTIVES: We examined racial/ethnic disparities in HIV infection among injection drug users (IDUs) before and after implementation of large-scale syringe exchange programs in New York City. METHODS: Participants were recruited from IDUs entering the Beth Israel drug detoxification program in New York City. Participants (n = 1203) recruited from 1990 through 1994, prior to large-scale syringe exchange programs (pre-exchange), were compared with 1109 participants who began injecting in 1995 or later and were interviewed in 1995 through 2008 (post-exchange). RESULTS: There were large differences in HIV prevalence among pre-exchange vs post-exchange participants (African Americans, 57% vs 15%; Hispanics, 53% vs 5%; Whites, 27% vs 3%). Pre- and post-exchange relative disparities of HIV prevalence were similar for African Americans vs Whites (adjusted odds ratio [AOR] = 3.46, 95% confidence interval [CI] = 2.41, 4.96 and AOR = 4.02, 95% CI = 1.67, 9.69, respectively) and Hispanics vs Whites (AOR = 1.76, 95% CI = 1.49, 2.09 and AOR = 1.49, 95% CI = 1.02, 2.17). Racial/ethnic group differences in risk behavior did not explain differences in HIV prevalence. CONCLUSIONS: New interventions are needed to address continuing disparities in HIV infection among IDUs, but self-reported risk behaviors by themselves may not be adequate outcome measures for evaluating interventions to reduce racial/ethnic disparities in HIV infection.

Author information

Author/s: Des Jarlais, Don C (DC); Arasteh, Kamyar (K); Hagan, Holly (H); McKnight, Courtney (C); Perlman, David C (DC); Friedman, Samuel R (SR);

Affiliation: Beth Israel Medical Center, 160 Water St-24th Fl, New York, NY 10038, USA. dcdesjarla(-atsign-)aol.com

Grants: 2 P30 DA 11041 (Agency:NIDA NIH HHS) ; R01 DA003574 (Agency:NIDA NIH HHS) ; R01DA024612 (Agency:NIDA NIH HHS)

Journal and publication information

Publication Type: Journal Article; Research Support, N.I.H., Extramural

Journal: American journal of public health (Am J Public Health), published in United States. (Language: eng)

Reference: 2009-Oct; vol 99 Suppl 2 (issue ) : pp S445-51

Dates: Created 2009/10/02; Completed 2009/10/26;

PMID: 19797757, status: MEDLINE (last retrieval date: 10/26/2009, IMS Date: )

Sourced from the National Library of Medicine. Abstract text and other information may be subject to copyright.

External Links for this article
(including full text providers, if available):

Click Electronic Full-text Provider Links to see options for finding the electronic full text links to this article. Note there may be a subscription or fee required for access to the full text. See our FAQ for information on finding FREE full text articles.

This article may also be located in paper journal collections available in many libraries. Use the Journal and Publication Information above to find the full article.