{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,22]],"date-time":"2026-07-22T05:39:54Z","timestamp":1784698794024,"version":"3.55.0"},"reference-count":45,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2012,10,18]],"date-time":"2012-10-18T00:00:00Z","timestamp":1350518400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Addiction"],"published-print":{"date-parts":[[2012,12]]},"abstract":"Abstract<\/jats:title>Aims<\/jats:title>The Ethnic Minority Meta\u2010Analysis (EMMA<\/jats:styled-content>) aims to assess racial\/ethnic disparities in HIV<\/jats:styled-content> infection among people who inject drugs (PWID<\/jats:styled-content>) across various countries. This is the first report of the data.<\/jats:p><\/jats:sec>Methods<\/jats:title>Standard systematic review\/meta\u2010analysis methods were utilized, including searching for, screening and coding published and unpublished reports and meta\u2010analytical statistics. We followed the Preferred Reporting Items for Systematic reviews and Meta\u2010Analyses (PRISMA)<\/jats:styled-content> statement and Meta\u2010analysis of Observational Studies in Epidemiology (MOOSE)<\/jats:styled-content> guidelines for reporting methods. Disparities were measured with the odds ratio (OR) for HIV<\/jats:styled-content> prevalence among ethnic minority PWID<\/jats:styled-content> compared to ethnic majority PWID<\/jats:styled-content>; an OR >1.0 indicated higher prevalence among ethnic minorities.<\/jats:p><\/jats:sec>Results<\/jats:title>Racial\/ethnic disparities in HIV<\/jats:styled-content> prevalence among PWID<\/jats:styled-content> were examined in 131 prevalence reports, with 214 racial\/ethnic minority to majority comparisons, comprising 106\u2009715 PWID<\/jats:styled-content>. Overall, the pooled OR<\/jats:styled-content> indicates an increased likelihood of higher HIV<\/jats:styled-content> prevalence among racial\/ethnic minority compared to racial\/ethnic majority PWID<\/jats:styled-content> [OR<\/jats:styled-content>\u2009=\u20092.09, 95% confidence interval (CI<\/jats:styled-content>): 1.92\u20132.28]. Among 214 comparisons, 106 produced a statistically significant higher OR for minorities; in 102 comparisons the OR<\/jats:styled-content> was not significantly different from 1.0; six comparisons produced a statistically significant higher OR<\/jats:styled-content> for majority group members. Disparities were particularly large in the United States<\/jats:styled-content>, pooled OR<\/jats:styled-content>\u2009=\u20092.22 (95% CI:<\/jats:styled-content> 2.03\u20132.44). There was substantial variation in OR<\/jats:styled-content>s\u2014I<\/jats:styled-content><\/jats:italic>2<\/jats:sup>\u2009=\u200975.3%: interquartile range\u2009=\u20091.38\u20133.56\u2014and an approximate G<\/jats:styled-content>aussian distribution of the log OR<\/jats:styled-content>s.<\/jats:p><\/jats:sec>Conclusions<\/jats:title>Among people who inject drugs, ethnic minorities are approximately twice as likely to be HIV<\/jats:styled-content> seropositive than ethnic majorities. The great heterogeneity and G<\/jats:styled-content>aussian distribution suggest multiple causal factors and a need to tailor interventions to local conditions.<\/jats:p><\/jats:sec>","DOI":"10.1111\/j.1360-0443.2012.04027.x","type":"journal-article","created":{"date-parts":[[2012,7,24]],"date-time":"2012-07-24T10:13:29Z","timestamp":1343124809000},"page":"2087-2095","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":30,"title":["Racial\/ethnic disparities in HIV<\/scp> infection among people who inject drugs: an international systematic review and meta\u2010analysis"],"prefix":"10.1111","volume":"107","author":[{"given":"Don C.","family":"Des Jarlais","sequence":"first","affiliation":[{"name":"The Baron Edmond de Rothschild Chemical Dependency Institute Beth Israel Medical Center New York NY USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Heidi A.","family":"Bramson","sequence":"additional","affiliation":[{"name":"The Baron Edmond de Rothschild Chemical Dependency Institute Beth Israel Medical Center New York NY USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cherise","family":"Wong","sequence":"additional","affiliation":[{"name":"The Baron Edmond de Rothschild Chemical Dependency Institute Beth Israel Medical Center New York NY USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karla","family":"Gostnell","sequence":"additional","affiliation":[{"name":"The Baron Edmond de Rothschild Chemical Dependency Institute Beth Israel Medical Center New York NY USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Javier","family":"Cepeda","sequence":"additional","affiliation":[{"name":"Yale School of Public Health New Haven CT USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kamyar","family":"Arasteh","sequence":"additional","affiliation":[{"name":"The Baron Edmond de Rothschild Chemical Dependency Institute Beth Israel Medical Center New York NY USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Holly","family":"Hagan","sequence":"additional","affiliation":[{"name":"College of Nursing New York University New York NY USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2012,10,18]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1177\/1077558708323607"},{"key":"e_1_2_6_3_1","unstructured":"US Department of Health and Human Services.HHS action plan to reduce racial and ethnic health disparities: a nation free of disparities in health and health care.Washington DC:Department of Health and Human Services;2011."},{"key":"e_1_2_6_4_1","volume-title":"Health and Freedom from Discrimination","author":"World Health Organization","year":"2001"},{"key":"e_1_2_6_5_1","unstructured":"National Institutes of Health (NIH).NIH policy on reporting race and ethnicity data: subjects in clinical research. 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