PURPOSE: To assess cross-population linkages in HIV/AIDS epidemics, we tested the hypothesis that the number of newly diagnosed AIDS cases among Black people who inject drugs (PWID) was positively related to the natural log of the rate of newly diagnosed HIV infections among Black non-PWID heterosexuals in 84 large US metropolitan statistical areas (MSA) in 2008-2016.
METHODS: We estimated a multilevel model centering the time-varying continuous exposures at baseline between the independent (Black PWID AIDS rates) and dependent (HIV diagnoses rate among Black heterosexuals) variables.
RESULTS: At MSA level, baseline (standardized beta=0.12) Black PWID AIDS rates and change in these rates over time (standardized beta=0.11) were positively associated with the log of new HIV diagnoses rates among Black heterosexuals. Thus, MSAs with Black PWID AIDS rates that were one standard deviation higher at baseline also had rates of newly diagnosed HIV infections among Black non-PWID heterosexuals that were 10.3% higher. A one standard deviation increase in independent variable over time corresponded to 7.8% increase in dependent variable.
CONCLUSIONS: Black PWID AIDS rates may predict HIV rates among non-PWID Black heterosexuals. Effective HIV programming may be predicated, in part, on addressing intertwining of HIV epidemics across populations.
Evidence for HIV transmission across key populations: A longitudinal analysis of HIV and AIDS rates among Black people who inject drugs and Black heterosexuals in 84 large US metropolitan areas, 2008-2016
Annals of Epidemiology, 55, 69-77. doi: 10.1016/j.annepidem.2020.10.003.