title: Persistent racial/ethnic disparities in AIDS diagnosis rates among people who inject drugs in U.S. metropolitan areas, 1993-2007.
abstract: OBJECTIVE
  We estimated race/ethnicity-specific incident AIDS diagnosis rates (IARs) among people who inject drugs (PWID) in U.S. metropolitan statistical areas (MSAs) over time to assess the change in disparities after highly active antiretroviral therapy (HAART) dissemination.
  
  
  METHODS
  We compared IARs and 95% confidence intervals (CIs) for black/African American and Hispanic/Latino PWID with those of white PWID in 93 of the most populous MSAs. We selected two three-year periods from the years immediately preceding HAART (1993-1995) and the years with the most recent available data (2005-2007). To maximize stability, we aggregated data across three-year periods, and we aggregated data for black/African American and Hispanic/Latino PWID for most comparisons with data for white PWID. We assessed disparities by comparing IAR 95% CIs for overlap.
  
  
  RESULTS
  IARs were significantly higher for black/African American and Hispanic/Latino PWID than for white PWID in 81% of MSAs in 1993-1995 and 77% of MSAs in 2005-2007. MSAs where disparities became non-significant over time were concentrated in the West. Significant differences were more frequent in comparisons between black/African American and white PWID (85% of MSAs in 1993-1995, 79% of MSAs in 2005-2007) than in comparisons between Hispanic/Latino and white PWID (53% of MSAs in 1993-1995, 56% of MSAs in 2005-2007). IARs declined modestly across racial/ethnic groups in most MSAs.
  
  
  CONCLUSIONS
  AIDS diagnosis rates continue to be substantially higher for black/African American and Hispanic/Latino PWID than for white PWID in most large MSAs. This finding suggests a need for increased targeting of prevention and treatment programs, as well as research on MSA-level conditions that may serve to maintain the disparities.
authors.affiliation: National Development and Research Institutes, Inc., New York, NY.
authors.forename: Enrique R
authors.initials: ER
authors.lastname: Pouget
authors.affiliation: National Development and Research Institutes, Inc., New York, NY.
authors.forename: Brooke S
authors.initials: BS
authors.lastname: West
authors.affiliation: National Development and Research Institutes, Inc., New York, NY.
authors.forename: Barbara
authors.initials: B
authors.lastname: Tempalski
authors.affiliation: Emory University, Rollins School of Public Health, Atlanta, GA.
authors.forename: Hannah L F
authors.initials: HL
authors.lastname: Cooper
authors.affiliation: Centers for Disease Control and Prevention, Atlanta, GA.
authors.forename: H Irene
authors.initials: HI
authors.lastname: Hall
authors.affiliation: Centers for Disease Control and Prevention, Atlanta, GA.
authors.forename: Xiaohong
authors.initials: X
authors.lastname: Hu
authors.affiliation: National Development and Research Institutes, Inc., New York, NY.
authors.forename: Samuel R
authors.initials: SR
authors.lastname: Friedman
mesh_terms: D000163:Acquired Immunodeficiency Syndrome / Q000175:diagnosis* / Q000208:ethnology*; D001741:Black or African American / Q000706:statistics & numerical data; D005006:Ethnicity / Q000706:statistics & numerical data*; D054625:Healthcare Disparities / Q000706:statistics & numerical data; D006630:Hispanic or Latino / Q000706:statistics & numerical data; D006801:Humans; D015994:Incidence; D044469:Racial Groups / Q000706:statistics & numerical data*; D015819:Substance Abuse, Intravenous / Q000208:ethnology*; D014481:United States; D014505:Urban Population / Q000706:statistics & numerical data; D044465:White People / Q000706:statistics & numerical data