228353 Racial/Ethnic Disparities in HIV Among IDUs in the United States and Other Countries: Results from a Meta-analysis of the International Literature on Racial/Ethnic Disparities in HIV Infection among IDUs

Tuesday, November 9, 2010 : 9:45 AM - 10:00 AM

Heidi Bramson, MPH , Baron Edmond de Rothschild Chemical Dependency Institute, Beth Israel Medical Center, New York, NY
Don C. Des Jarlais, PhD , Baron Edmond de Rothschild Chemical Dependency Institute, Beth Israel Medical Center, New York, NY
Cherise Wong, MSc , Baron Edmond de Rothschild Chemical Dependency Institute, Beth Israel Medical Center, New York, NY
Karla Gostnell, MPH , Baron Edmond de Rothschild Chemical Dependency Institute, Beth Israel Medical Center, New York, NY
Kamyar Arasteh, PhD , Baron Edmond de Rothschild Chemical Dependency Institute, Beth Israel Medical Center, New York, NY
Holly Hagan, PhD , College of Nursing, New York University, New York, NY
     
Background: Higher rates of HIV infection among racial/ethnic minority injecting drug users (IDUs) have been reported in North America, South America, Europe and Asia.

Methods: Standard systematic review/meta-analysis methods are utilized, including searching for published and unpublished reports, standardized screening and coding, and meta-analytic statistical techniques.

Results: As of February 1, 2009, 22,635 abstracts were reviewed; 1730 papers were retrieved for further review and potential coding; 110 studies were eligible for inclusion in the meta-analysis and coded: 1) Ethnic disparities were examined in 78 prevalence studies, with 134 ethnic minority to ethnic majority comparisons. A plurality (45) of comparisons was from the US, followed by China (8), and Canada (6). 2) 108 (81%) comparisons showed higher HIV prevalence among ethnic minority IDUs, two (2%) comparisons found identical HIV prevalence, and 24 (18%) comparisons found lower HIV prevalence among ethnic minority IDUs. The mean weighted OR for HIV prevalence in ethnic minority compared to ethnic majority IDUs was 2.41(95% CI 2.30-2.51). 3) The mean weighted OR for HIV prevalence in US Black:White comparisons was 3.13 (95% CI 2.90-3.38), significantly greater than the mean weighted OR for the other ethnic minority:majority comparisons. 4) There was great heterogeneity among the studies (I squared = 86%).

Conclusion: Higher HIV prevalence among ethnic minority IDUs is very common but not inevitable. The great heterogeneity among the studies suggests multiple causal factors contribute to ethnic disparities in HIV infection. Possible reasons for greater disparity in US Black:White comparisons than other ethnic minority:majority comparisons will be discussed.

Learning Areas:
Epidemiology
Social and behavioral sciences

Learning Objectives:
1. Demonstrate the importance of racial/ethnic disparities in HIV infection among injecting drug users. 2. Explain international aspects of HIV disparities among injecting drug users. 3. Identify methodological issues in measuring HIV risk among different ethnic groups of injecting drug users.

Keywords: Health Disparities, HIV/AIDS

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am qualified because I am the Project Director of a meta-analysis reviewing the international literature on HIV/AIDS in injection drug users spanning 1985-2010. This Meta-analysis is specifically looking at the HIV disparities found in racial/ethnic minority injection drug users.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

Back to: 4037.0: Injecting Drug Use and HIV/AIDS