Abstract：
PURPOSE:We estimated female and male incident AIDS diagnosis rates (IARs) among people who inject drugs (PWID) in U.S. metropolitan statistical areas (MSAs) over time to assess whether declines in IARs varied by sex after combination antiretroviral therapy (cART) dissemination. METHODS:We compared IARs and 95% confidence intervals for female and male PWID in 95 of the most populous MSAs. To stabilize estimates, we aggregated data across three-year periods, selecting a period immediately preceding cART (1993-1995) and the most recent after the introduction of cART for which data were available (2005-2007). We assessed disparities by comparing IAR 95% confidence intervals for overlap, female-to-male risk ratios, and disparity change scores. RESULTS:IARs declined an average of 58% for female PWID and 67% for male PWID between the pre-cART and cART periods. Among female PWID, IARs were significantly lower in the later period relative to the pre-cART period in 48% of MSAs. Among male PWID, IARs were significantly lower over time in 86% of MSAs. CONCLUSIONS:IARs among female PWID in large U.S. MSAs have declined more slowly than among male PWID. This suggests a need for increased targeting of prevention and treatment programs and for research on MSA level conditions that may drive differences in declining AIDS rates among female and male PWID.
journal_name
Ann Epidemioljournal_title
Annals of epidemiologyauthors
West BS,Pouget ER,Tempalski B,Cooper HL,Hall HI,Hu X,Friedman SRdoi
10.1016/j.annepidem.2015.01.006subject
Has Abstractpub_date
2015-04-01 00:00:00pages
218-25issue
4eissn
1047-2797issn
1873-2585pii
S1047-2797(15)00028-9journal_volume
25pub_type
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