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. 2009 Oct;99 Suppl 2(Suppl 2):S445-51.
doi: 10.2105/AJPH.2008.159327.

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

Don C Des Jarlais  1 , Kamyar Arasteh, Holly Hagan, Courtney McKnight, David C Perlman, Samuel R Friedman
Affiliations

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

Don C Des Jarlais et al. Am J Public Health. 2009 Oct.

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.

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