Persistent Racial Disparities in HIV Infection in the USA: HIV Prevalence Matters
OBJECTIVES:
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.
METHODS:
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 %).
RESULTS:
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.
CONCLUSIONS:
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.
- 1HIV 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.
- 2HIV Epidemiology and Field Services Program, New York City Department of Health and Mental Hygiene, 42-09 28th St, Queens, NY, 11101, USA.
- 3Yale University School of Public Health, New Haven, CT, USA.
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