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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.

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  • 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
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    References listed on IDEAS

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    1. 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.
    2. 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.
    3. 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.

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