Τίτλος:
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
Γλώσσες Τεκμηρίου:
Αγγλικά
Περίληψη:
Background
There 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).
Methods
We 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.
Findings
In 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.
Interpretation
Given 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.
Συγγραφείς:
Nikolopoulos, Georgios K.
Fotiou, Anastasios
Kanavou, Eleftheria
and Richardson, Clive
Detsis, Marios
Pharris, Anastasia
Suk,
Jonathan E.
Semenza, Jan C.
Costa-Storti, Claudia and
Paraskevis, Dimitrios
Sypsa, Vana
Malliori, Melpomeni-Minerva
and Friedman, Samuel R.
Hatzakis, Angelos
Εκδότης:
Public Library of Science
DOI:
10.1371/journal.pone.0122367
