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About the Authors:
Samuel R. Friedman
* E-mail: [email protected]
Affiliation: Institute of Infectious Disease Research, National Development and Research Institutes, Inc., New York, New York, United States of America
Brooke S. West
Affiliation: Institute of Infectious Disease Research, National Development and Research Institutes, Inc., New York, New York, United States of America
Enrique R. Pouget
Affiliation: Institute of Infectious Disease Research, National Development and Research Institutes, Inc., New York, New York, United States of America
H. Irene Hall
Affiliation: Centers for Disease Control, Atlanta, Georgia, United States of America
Jennifer Cantrell
Affiliation: Legacy Foundation, Washington, D. C., United States of America
Barbara Tempalski
Affiliation: Institute of Infectious Disease Research, National Development and Research Institutes, Inc., New York, New York, United States of America
Sudip Chatterjee
Affiliation: Independent Consultant, Bangalore, India
Xiaohong Hu
Affiliation: Centers for Disease Control, Atlanta, Georgia, United States of America
Hannah L. F. Cooper
Affiliation: Department of Behavioral Sciences and Health Education, Emory University, Atlanta, Georgia, United States of America
Sandro Galea
Affiliation: Department of Epidemiology, Columbia University, New York, New York, United States of America
Don C. Des Jarlais
Affiliations Institute of Infectious Disease Research, National Development and Research Institutes, Inc., New York, New York, United States of America, Baron Edmond de Rothschild Chemical Dependency Institute at Beth Israel Medical Center, New York, New York, United States of America
Introduction
Antiretroviral therapy (ART) can delay or prevent HIV-related mortality for people who inject drugs and who have access to and can adhere to treatment regimens [1]. While understanding individual characteristics is important for clinical decision making, public health strategies require a broader understanding of social environmental processes that shape mortality for high risk groups. These can include service provision adequacy and quality, plus other factors that affect levels of access to ART or treatment adherence. They may also include factors that affect mortality independently of, or in interaction with, ART access and use. Krusi et al. recently called for studies of social and structural determinants of ART access and adherence among injection drug users (IDUs) [2]. This paper aims at a related goal: it explores how characteristics of 86 large US metropolitan areas (MSAs) were associated with changes in AIDS mortality since the pre-HAART period among IDUs living with AIDS [3],...