title: Persistent Racial Disparities in HIV Infection in the USA: HIV Prevalence Matters.
abstract: Despite increased funding and efforts to prevent and control HIV infections in the black and Hispanic communities, racial disparities persist in the USA. We used a mathematical model to explain the phenomena.
  
  
  
  A mathematical model was constructed to project HIV prevalence ratio (PR), incidence rate ratio (IRR), and HIV-specific mortality rate ratio (MRR) among blacks and Hispanics vs. whites in two scenarios: (1) an annual reduction in HIV incidence rate at the 2007-2010 level and (2) an annual reduction in HIV incidence rate at the 2007-2010 level among whites (4.2 %) and twice that of whites among blacks and Hispanics (8.4 %).
  
  
  
  In scenario no. 1, the PR, IRR, and MRR among blacks would decrease from 7.6 to 5.8, 7.9 to 5.9, and 11.3 to 5.3 and among Hispanics from 2.8 to 1.8, 3.1 to 1.9, and 2.3 to 1.0, respectively. In scenario no. 2, the PR, IRR, and MRR among blacks would decrease from 7.6 to 5.1, 7.9 to 2.5, and 11.3 to 4.7 and among Hispanics from 2.8 to 1.6, 3.1 to 0.8, and 2.3 to 0.9, respectively.
  
  
  
  Much of the persistent racial disparities in HIV infection in the USA, as measured by PR, IRR, and MRR, can be explained by higher HIV prevalence among blacks and Hispanics. The public health community should continue its efforts to reduce racial disparities, but also need to set realistic goals and measure progress with sensitive indicators.
authors.affiliation: HIV Epidemiology and Field Services Program, New York City Department of Health and Mental Hygiene, 42-09 28th St, Queens, NY, 11101, USA. qxia@health.nyc.gov.
authors.forename: Qiang
authors.identifier: 0000-0002-2493-6001
authors.initials: Q
authors.lastname: Xia
authors.affiliation: HIV Epidemiology and Field Services Program, New York City Department of Health and Mental Hygiene, 42-09 28th St, Queens, NY, 11101, USA.
authors.forename: Sarah L
authors.initials: SL
authors.lastname: Braunstein
authors.affiliation: HIV Epidemiology and Field Services Program, New York City Department of Health and Mental Hygiene, 42-09 28th St, Queens, NY, 11101, USA.
authors.forename: Ellen W
authors.initials: EW
authors.lastname: Wiewel
authors.affiliation: Yale University School of Public Health, New Haven, CT, USA.
authors.forename: James L
authors.initials: JL
authors.lastname: Hadler
authors.affiliation: HIV Epidemiology and Field Services Program, New York City Department of Health and Mental Hygiene, 42-09 28th St, Queens, NY, 11101, USA.
authors.forename: Lucia V
authors.initials: LV
authors.lastname: Torian
mesh_terms: D001741:Black or African American / Q000706:statistics & numerical data*; D015658:HIV Infections / Q000208:ethnology* / Q000401:mortality; D054624:Health Status Disparities; D006630:Hispanic or Latino / Q000706:statistics & numerical data*; D006801:Humans; D015994:Incidence; D008962:Models, Theoretical; D015995:Prevalence; D014481:United States / Q000453:epidemiology; D044465:White People / Q000706:statistics & numerical data*
keywords: HIV; Mathematical model; Racial disparity; USA