Black-White mortality from HIV in the United States before and after introduction of highly active antiretroviral therapy in 1996.
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| Title: | Black-White mortality from HIV in the United States before and after introduction of highly active antiretroviral therapy in 1996. |
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| Authors: | Levine RS (AUTHOR), Briggs NC (AUTHOR), Kilbourne BS (AUTHOR), King WD (AUTHOR), Fry-Johnson Y (AUTHOR), Baltrus PT (AUTHOR), Husaini BA (AUTHOR), Rust GS (AUTHOR) |
| Source: | American Journal of Public Health. Oct2007, Vol. 97 Issue 10, p1884-1892. 9p. |
| Subjects: | Mortality, HIV infections, Highly active antiretroviral therapy, Black people, White people, Ethnicity, Diseases |
| Geographic Terms: | United States |
| Abstract: | OBJECTIVES: We sought to describe Black-White differences in HIV disease mortality before and after the introduction of highly active antiretroviral treatment (HAART). METHODS: Black-White mortality from HIV is described for the nation as a whole. We performed regression analyses to predict county-level mortality for Black men aged 25-84 years and the corresponding Black:White male mortality ratios (disparities) in 140 counties with reliable Black mortality for 1999-2002. RESULTS: National Black-White disparities widened significantly after the introduction of HAART, especially among women and the elderly. In county regression analyses, contextual socioeconomic status (SES) was not a significant predictor of Black:White mortality rate ratio after we controlled for percentage of the population who were Black and percentage of the population who were Hispanic, and neither contextual SES nor race/ethnicity were significant predictors after we controlled for pre-HAART mortality. Contextual SES, race, and pre-HAART mortality were all significant and independent predictors of mortality among Black men. CONCLUSIONS: Although nearly all segments of the Black population experienced widened post-HAART disparities, disparities were not inevitable and tended to reflect pre-HAART levels. Public health policymakers should consider the hypothesis of unequal diffusion of the HAART innovation, with place effects rendering some communities more vulnerable than others to this potential problem. [ABSTRACT FROM AUTHOR] |
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| Database: | Psychology and Behavioral Sciences Collection |
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| Abstract: | OBJECTIVES: We sought to describe Black-White differences in HIV disease mortality before and after the introduction of highly active antiretroviral treatment (HAART). METHODS: Black-White mortality from HIV is described for the nation as a whole. We performed regression analyses to predict county-level mortality for Black men aged 25-84 years and the corresponding Black:White male mortality ratios (disparities) in 140 counties with reliable Black mortality for 1999-2002. RESULTS: National Black-White disparities widened significantly after the introduction of HAART, especially among women and the elderly. In county regression analyses, contextual socioeconomic status (SES) was not a significant predictor of Black:White mortality rate ratio after we controlled for percentage of the population who were Black and percentage of the population who were Hispanic, and neither contextual SES nor race/ethnicity were significant predictors after we controlled for pre-HAART mortality. Contextual SES, race, and pre-HAART mortality were all significant and independent predictors of mortality among Black men. CONCLUSIONS: Although nearly all segments of the Black population experienced widened post-HAART disparities, disparities were not inevitable and tended to reflect pre-HAART levels. Public health policymakers should consider the hypothesis of unequal diffusion of the HAART innovation, with place effects rendering some communities more vulnerable than others to this potential problem. [ABSTRACT FROM AUTHOR] |
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| ISSN: | 00900036 |
| DOI: | 10.2105/AJPH.2005.081489 |
