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.
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 p...
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doaj-5848267949b44ebfb3b35e90999d0be22020-11-25T01:58:56ZengPublic Library of Science (PLoS)PLoS ONE1932-62032015-01-01104e012236710.1371/journal.pone.0122367National 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.Georgios K NikolopoulosAnastasios FotiouEleftheria KanavouClive RichardsonMarios DetsisAnastasia PharrisJonathan E SukJan C SemenzaClaudia Costa-StortiDimitrios ParaskevisVana SypsaMelpomeni-Minerva MallioriSamuel R FriedmanAngelos HatzakisBACKGROUND: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.http://europepmc.org/articles/PMC4398461?pdf=render |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Georgios K Nikolopoulos Anastasios Fotiou Eleftheria Kanavou Clive Richardson Marios Detsis Anastasia Pharris Jonathan E Suk Jan C Semenza Claudia Costa-Storti Dimitrios Paraskevis Vana Sypsa Melpomeni-Minerva Malliori Samuel R Friedman Angelos Hatzakis |
spellingShingle |
Georgios K Nikolopoulos Anastasios Fotiou Eleftheria Kanavou Clive Richardson Marios Detsis Anastasia Pharris Jonathan E Suk Jan C Semenza Claudia Costa-Storti Dimitrios Paraskevis Vana Sypsa Melpomeni-Minerva Malliori Samuel R Friedman Angelos Hatzakis 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. PLoS ONE |
author_facet |
Georgios K Nikolopoulos Anastasios Fotiou Eleftheria Kanavou Clive Richardson Marios Detsis Anastasia Pharris Jonathan E Suk Jan C Semenza Claudia Costa-Storti Dimitrios Paraskevis Vana Sypsa Melpomeni-Minerva Malliori Samuel R Friedman Angelos Hatzakis |
author_sort |
Georgios K Nikolopoulos |
title |
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. |
title_short |
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. |
title_full |
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. |
title_fullStr |
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. |
title_full_unstemmed |
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. |
title_sort |
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. |
publisher |
Public Library of Science (PLoS) |
series |
PLoS ONE |
issn |
1932-6203 |
publishDate |
2015-01-01 |
description |
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. |
url |
http://europepmc.org/articles/PMC4398461?pdf=render |
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