IDEAS home Printed from https://ideas.repec.org/a/plo/pone00/0122367.html
   My bibliography  Save this article

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

Author

Listed:
  • 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

Abstract

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.

Suggested Citation

  • Georgios K Nikolopoulos & Anastasios Fotiou & Eleftheria Kanavou & Clive Richardson & Marios Detsis & Anastasia Pharris & Jonathan E Suk & Jan C Semenza & Claudia Costa-Storti & Dimitrios Paraskevis &, 2015. "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, Public Library of Science, vol. 10(4), pages 1-13, April.
    • Handle: RePEc:plo:pone00:0122367
    DOI: 10.1371/journal.pone.0122367
    as

    Download full text from publisher

    File URL: https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0122367
    Download Restriction: no
    File URL: https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0122367&type=printable
    Download Restriction: no
    File URL: https://libkey.io/10.1371/journal.pone.0122367?utm_source=ideas
    LibKey link: if access is restricted and if your library uses this service, LibKey will redirect you to where you can use your library subscription to access this item
    ---><---

    References listed on IDEAS

    as
    1. Sypsa, V. & Paraskevis, D. & Malliori, M. & Nikolopoulos, G.K. & Panopoulos, A. & Kantzanou, M. & Katsoulidou, A. & Psichogiou, M. & Fotiou, A. & Pharris, A. & Van De Laar, M. & Wiessing, L. & Des Jar, 2015. "Homelessness and other risk factors for HIV infection in the current outbreak among injection drug users in Athens, Greece," American Journal of Public Health, American Public Health Association, vol. 105(1), pages 196-204.
    2. Robert Costanza & Ida Kubiszewski & Enrico Giovannini & Hunter Lovins & Jacqueline McGlade & Kate E. Pickett & Kristín Vala Ragnarsdóttir & Debra Roberts & Roberto De Vogli & Richard Wilkinson, 2014. "Development: Time to leave GDP behind," Nature, Nature, vol. 505(7483), pages 283-285, January.
    3. Göran Holmqvist, 2009. "HIV and Income Inequality: If There Is a Link, What Does It Tell Us?," Working Papers 54, International Policy Centre for Inclusive Growth.
    4. Marc Suhrcke & David Stuckler & Jonathan E Suk & Monica Desai & Michaela Senek & Martin McKee & Svetla Tsolova & Sanjay Basu & Ibrahim Abubakar & Paul Hunter & Boika Rechel & Jan C Semenza, 2011. "The Impact of Economic Crises on Communicable Disease Transmission and Control: A Systematic Review of the Evidence," PLOS ONE, Public Library of Science, vol. 6(6), pages 1-12, June.
    5. Göran Holmqvist, 2009. "HIV and Income Inequality: If There is a Link, What Does It Tell Us?," One Pager 83, International Policy Centre for Inclusive Growth.
    6. Ram, Rati, 2005. "Income inequality, poverty, and population health: Evidence from recent data for the United States," Social Science & Medicine, Elsevier, vol. 61(12), pages 2568-2576, December.
    7. Sophia Rabe-Hesketh & Anders Skrondal, 2012. "Multilevel and Longitudinal Modeling Using Stata, 3rd Edition," Stata Press books, StataCorp LP, edition 3, number mimus2, March.
    8. Biggs, Brian & King, Lawrence & Basu, Sanjay & Stuckler, David, 2010. "Is wealthier always healthier? The impact of national income level, inequality, and poverty on public health in Latin America," Social Science & Medicine, Elsevier, vol. 71(2), pages 266-273, July.
    Full references (including those not matched with items on IDEAS)

    Citations

    Citations are extracted by the CitEc Project, subscribe to its RSS feed for this item.
    as


    Cited by:

    1. Mahmoud Salameh Qandeel, 2024. "Implications of public policies performance on social inequality worldwide," SN Business & Economics, Springer, vol. 4(9), pages 1-33, September.
    2. Whenayon Simeon Ajisegiri & Abrar Ahmad Chughtai & C. Raina MacIntyre, 2018. "A Risk Analysis Approach to Prioritizing Epidemics: Ebola Virus Disease in West Africa as a Case Study," Risk Analysis, John Wiley & Sons, vol. 38(3), pages 429-441, March.
    3. George Giallouros & Katerina Pantavou & Despina Pampaka & Eirini Pavlitina & Daniele Piovani & Stefanos Bonovas & Georgios K. Nikolopoulos, 2021. "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," IJERPH, MDPI, vol. 18(5), pages 1-13, March.
    4. Seong-Uk Baek & Sung-Shil Lim & Jihyun Kim & Jin-Ha Yoon, 2019. "How Does Economic Inequality Affect Infanticide Rates? An Analysis of 15 Years of Death Records and Representative Economic Data," IJERPH, MDPI, vol. 16(19), pages 1-12, September.

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Lloyd, Simon J. & Bangalore, Mook & Chalabi, Zaid & Kovats, R. Sari & Hallegatte, Stèphane & Rozenberg, Julie & Valin, Hugo & Havlik, Petr, 2018. "A global-level model of the potential impacts of climate change on child stunting via income and food price in 2030," LSE Research Online Documents on Economics 90594, London School of Economics and Political Science, LSE Library.
    2. Travis W Lim & Constantine Frangakis & Carl Latkin & Tran Viet Ha & Nguyen Le Minh & Carla Zelaya & Vu Minh Quan & Vivian F Go, 2014. "Community-Level Income Inequality and HIV Prevalence among Persons Who Inject Drugs in Thai Nguyen, Vietnam," PLOS ONE, Public Library of Science, vol. 9(3), pages 1-8, March.
    3. Durevall, Dick & Lindskog, Annika, 2012. "Economic Inequality and HIV in Malawi," World Development, Elsevier, vol. 40(7), pages 1435-1451.
    4. María Jesús Rodríguez-Gulías & David Rodeiro-Pazos & Sara Fernández-López & Manuel Ángel Nogueira-Moreiras, 2021. "The effect of regional resources on innovation: a firm-centered approach," The Journal of Technology Transfer, Springer, vol. 46(3), pages 760-791, June.
    5. Eloi Laurent & Jean Jouzel, 2018. "The Well-being Transition: Measuring what counts to protect what matters," SciencePo Working papers Main hal-03458057, HAL.
    6. Moorman, Sara M. & Carr, Kyle & Greenfield, Emily A., 2018. "Childhood socioeconomic status and genetic risk for poorer cognition in later life," Social Science & Medicine, Elsevier, vol. 212(C), pages 219-226.
    7. Babigumira, Ronnie & Angelsen, Arild & Buis, Maarten & Bauch, Simone & Sunderland, Terry & Wunder, Sven, 2014. "Forest Clearing in Rural Livelihoods: Household-Level Global-Comparative Evidence," World Development, Elsevier, vol. 64(S1), pages 67-79.
    8. Alvaro Forteza & Cecilia Noboa, 2019. "Perceptions of institutional quality and justification of tax evasion," Constitutional Political Economy, Springer, vol. 30(4), pages 367-382, December.
    9. Gabriele B. Durrant & Sylke V. Schnepf, 2018. "Which schools and pupils respond to educational achievement surveys?: a focus on the English Programme for International Student Assessment sample," Journal of the Royal Statistical Society Series A, Royal Statistical Society, vol. 181(4), pages 1057-1075, October.
    10. Nils Grashof, 2020. "Sinking or swimming in the cluster labour pool? A firm-specific analysis of the effect of specialized labour," Jena Economics Research Papers 2020-006, Friedrich-Schiller-University Jena.
    11. Yeojin Chung & Sophia Rabe-Hesketh & Vincent Dorie & Andrew Gelman & Jingchen Liu, 2013. "A Nondegenerate Penalized Likelihood Estimator for Variance Parameters in Multilevel Models," Psychometrika, Springer;The Psychometric Society, vol. 78(4), pages 685-709, October.
    12. Ioana Pop & Erik Ingen & Wim Oorschot, 2013. "Inequality, Wealth and Health: Is Decreasing Income Inequality the Key to Create Healthier Societies?," Social Indicators Research: An International and Interdisciplinary Journal for Quality-of-Life Measurement, Springer, vol. 113(3), pages 1025-1043, September.
    13. Meyer, Sophie-Charlotte & Künn-Nelen, Annemarie, 2014. "Do Occupational Demands Explain the Educational Gradient in Health?," IZA Discussion Papers 8011, Institute of Labor Economics (IZA).
    14. Melissa P L Chan & Robert S Weinhold & Reuben Thomas & Julia M Gohlke & Christopher J Portier, 2015. "Environmental Predictors of US County Mortality Patterns on a National Basis," PLOS ONE, Public Library of Science, vol. 10(12), pages 1-25, December.
    15. Fielden, Sarah J. & Rusch, Melanie L. & Masinda, Mambo Tabu & Sands, Jim & Frankish, Jim & Evoy, Brian, 2007. "Key considerations for logic model development in research partnerships: A Canadian case study," Evaluation and Program Planning, Elsevier, vol. 30(2), pages 115-124, May.
    16. Arpino, Bruno & Varriale, Roberta, 2009. "Assessing the quality of institutions’ rankings obtained through multilevel linear regression models," MPRA Paper 19873, University Library of Munich, Germany.
    17. Miranda J. Welbourne Eleazar, 2022. "Immoral Entrenchment: How Crisis Reverses the Ethical Effects of Moral Intensity," Journal of Business Ethics, Springer, vol. 180(1), pages 71-89, September.
    18. Laura Resmini & Giuseppe Vittucci Marzetti, 2020. "Home bias in divestment decisions of multinational corporations in the EU," Review of International Economics, Wiley Blackwell, vol. 28(3), pages 799-813, August.
    19. Elizabeth S. Park & Federick Ngo & Tatiana Melguizo, 2021. "The Role of Math Misalignment in the Community College STEM Pathway," Research in Higher Education, Springer;Association for Institutional Research, vol. 62(4), pages 403-447, June.
    20. Viktor Stojkoski & Zoran Utkovski & Ljupco Kocarev, 2016. "The Impact of Services on Economic Complexity: Service Sophistication as Route for Economic Growth," PLOS ONE, Public Library of Science, vol. 11(8), pages 1-29, August.

    More about this item

    Statistics

    Access and download statistics

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:plo:pone00:0122367. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: plosone (email available below). General contact details of provider: https://journals.plos.org/plosone/ .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.