Abstract

MOPE109 - Poster Exhibition

Persistent racial/ethnic disparities in AIDS diagnoses among people who inject drugs in the largest US metropolitan areas, 1993-2008

E.R. Pouget¹, B.S. West¹, B. Tempalski¹, H.L.F. Cooper², H.I. Hall³, X. Hu³, S.R. Friedman<sup>1,4

1</sup>National Development and Research Institutes, Inc., Institute for AIDS Research, New York, United States, ²Emory University, Department of Behavioral Sciences and Health Education, Rollins School of Public Health, Atlanta, United States, ³Centers for Disease Control & Prevention, Atlanta, United States, ⁴Center for Drug Use and HIV Research, Director, Transdisciplinary Theoretical Synthesis Core, New York, United States

Background: In the US, African Americans and Hispanics have comprised the majority of AIDS diagnoses among people who inject drugs (PWID), even though they are estimated to have been only about a third of PWID. Harm reduction programs are believed to have been partly responsible for reducing HIV transmission among PWID since the 1980s, and HAART has greatly reduced rates of progression to AIDS; however, these benefits may not have spread evenly across racial/ethnic groups and across localities.
Methods: As part of an ongoing study of the 96 largest US metropolitan areas (MSAs), we compared change across time in the proportion of new AIDS diagnoses among PWID who reported either African American or Hispanic race/ethnicity, from the years most closely preceding HAART dissemination (1993-1995) to the most recent years with available data (2006-2008). Sufficient data for analysis were available for 88 of these MSAs.
Results: The median proportion of PWID AIDS diagnoses that were among African Americans or Hispanics was 0.71 during the most recent years, a slight increase from the pre-HAART period (0.69). The proportion who were African American or Hispanic declined across time by 10% or more in 20 MSAs, and increased by 10% or more in 17. African Americans and Hispanics comprised the majority of PWID AIDS diagnoses in 76 MSAs during 2006-2008, compared with 75 during the pre-HAART period.
Conclusions: Although whites are the majority of PWID, African Americans and Hispanics continue to comprise the majority of AIDS diagnoses among PWID across most MSAs. The lack of decline in racial/ethnic disparities suggests a need for research on MSA-level structural conditions that have been shown to have racially disparate effects on drug use, HIV infection and progression to AIDS, such as differences in education and HIV prevention programs, and differences in healthcare, including HIV-testing and HAART utilization.