Even when people with HIV have equal access to care for the virus, whites have a higher rate of successful treatment compared with their Black counterparts.
Publishing their findings in AIDS Patient Care and STDs, researchers conducted a study of 8,779 Black individuals and 7,836 white individuals in the Veterans Administration (VA) health system who received antiretroviral treatment for HIV during 2013.
Compared with the whites in the study cohort, Blacks were younger, had lower CD4 counts, more health conditions in addition to HIV, a lower rate of staying in medical care for the virus and poorer adherence to treatment.
Fifteen percent of the African Americans and 8 percent of the whites had an uncontrolled viral load, meaning that, overall, Blacks were 2.02-fold more likely to lack a fully suppressed virus compared with whites.
Next in their analysis, the researchers progressively controlled for various factors to see how doing so affected the disparity in the rate of lack of viral suppression among Blacks compared with whites. Controlling for the specific clinic site where individuals received their care reduced, or attenuated, the 2.02-fold difference to 1.83-fold. Controlling sequentially for age andvarious clinical characteristics of the study cohort members, retention in medical care and adherence to HIV treatment attenuated this difference to 1.65-fold, 1.62-fold and 1.24-fold, respectively.
The study authors concluded that 51 percent of the difference in the viral suppression rates between Blacks and whites was driven by differences in adherence to HIV treatment and 26 percent was driven by differences related to the specific sites where they received their medical care.
“Targeting poorer performing sites for quality improvement and focusing on improving antiretroviral adherence in Black patients may help alleviate disparities in viral control,” the investigators concluded.
To read a press release about the study, click here.
To read the study, click here.