ArticlePloS one2015
National income inequality and declining GDP growth rates are associated with increases in HIV diagnoses among people who inject drugs in Europe: a panel data analysis.
Article in PloS one, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 28 papers, 1 of them a synthesis that pooled it.
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Who cites it
28 citing papers in PubMed, 1 synthesis or guideline pooled it.
- How do economic crises affect migrants' risk of infectious disease? A systematic-narrative review.European journal of public health · 2015Pooled it
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- Is Economic Growth Good for Population Health? A Critical Review.Canadian studies in population · 2023Review
- Sexual Mixing and HIV Transmission Potential Among Greek Men Who have Sex with Men: Results from SOPHOCLES.AIDS and behavior · 2021Article
- Drug Injection-Related and Sexual Behavior Changes in Drug Injecting Networks after the Transmission Reduction Intervention Project (TRIP): A Social Network-Based Study in Athens, Greece.International journal of environmental research and public health · 2021Article
- Could the 2010 HIV outbreak in Athens, Greece have been prevented? A mathematical modeling study.PloS one · 2021Article
- Hepatitis A Outbreaks Associated With the Opioid Epidemic in Kentucky Counties, 2017-2018.American journal of public health · 2020Article
- HIV outbreaks among people who inject drugs in Europe, North America, and Israel.The lancet. HIV · 2020Review
- Trends over time in HIV prevalence among people who inject drugs in 89 large US metropolitan statistical areas, 1992-2013.Annals of epidemiology · 2020Article
- High-risk behaviors and their association with awareness of HIV status among participants of a large-scale prevention intervention in Athens, Greece.BMC public health · 2020Article
- The Opioid/Overdose Crisis as a Dialectics of Pain, Despair, and One-Sided Struggle.Frontiers in public health · 2020Review
- Income Inequality, HIV Stigma, and Preventing HIV Disease Progression in Rural Communities.Prevention science : the official journal of the Society for Prevention Research · 2019Article
- How Does Economic Inequality Affect Infanticide Rates? An Analysis of 15 Years of Death Records and Representative Economic Data.International journal of environmental research and public health · 2019Article
- Housing First: Unsuppressed Viral Load Among Women Living with HIV in San Francisco.AIDS and behavior · 2019Article
- Assessing the influence of conflict on the dynamics of sex work and the HIV and HCV epidemics in Ukraine: protocol for an observational, ethnographic, and mathematical modeling study.BMC international health and human rights · 2019Observational
- Identifying Which Place Characteristics are Associated with the Odds of Recent HIV Testing in a Large Sample of People Who Inject Drugs in 19 US Metropolitan Areas.AIDS and behavior · 2019Article
- Molecular investigation of HIV-1 cross-group transmissions during an outbreak among people who inject drugs (2011-2014) in Athens, Greece.Infection, genetics and evolution : journal of molecular epidemiology and evolutionary genetics in infectious diseases · 2018Article
- The Syndemic of Opioid Misuse, Overdose, HCV, and HIV: Structural-Level Causes and Interventions.Current HIV/AIDS reports · 2018Review
- A Risk Analysis Approach to Prioritizing Epidemics: Ebola Virus Disease in West Africa as a Case Study.Risk analysis : an official publication of the Society for Risk Analysis · 2018Article
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Abstract
backgroundThere is sparse evidence that demonstrates the association between macro-environmental processes and drug-related HIV epidemics. The present study explores the relationship between economic, socio-economic, policy and structural indicators, and increases in reported HIV infections among people who inject drugs (PWID) in the European Economic Area (EEA).
methodsWe used panel data (2003-2012) for 30 EEA countries. Statistical analyses included logistic regression models. The dependent variable was taking value 1 if there was an outbreak (significant increase in the national rate of HIV diagnoses in PWID) and 0 otherwise. Explanatory variables included the growth rate of Gross Domestic Product (GDP), the share of the population that is at risk for poverty, the unemployment rate, the Eurostat S80/S20 ratio, the Gini coefficient, the per capita government expenditure on health and social protection, and variables on drug control policy and drug-using population sizes. Lags of one to three years were investigated.
findingsIn multivariable analyses, using two-year lagged values, we found that a 1% increase of GDP was associated with approximately 30% reduction in the odds of an HIV outbreak. In GDP-adjusted analyses with three-year lagged values, the effect of the national income inequality on the likelihood of an HIV outbreak was significant [S80/S20 Odds Ratio (OR) = 3.89; 95% Confidence Interval (CI): 1.15 to 13.13]. Generally, the multivariable analyses produced similar results across three time lags tested.
interpretationGiven the limitations of ecological research, we found that declining economic growth and increasing national income inequality were associated with an elevated probability of a large increase in the number of HIV diagnoses among PWID in EEA countries during the last decade. HIV prevention may be more effective if developed within national and European-level policy contexts that promote income equality, especially among vulnerable groups.
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