Herminia Palacio1, James G Kahn, T Anne Richards, Stephen F Morin. 1. Houston Center for Quality of Care and Utilization Studies, Veterans Affairs Medical Center (152), 2002 Holcombe Boulevard, Houston, TX 77030, USA. hpalacio@bcm.tmc.edu
Abstract
OBJECTIVE: The authors performed a systematic and critical review of published studies investigating potential associations between race and/or ethnicity and use of HIV-related medications, including antiretroviral medications and medications used for prophylaxis of opportunistic infections. METHODS: The authors conducted a Web-based search of the University of California MEDLINE/HealthSTAR database for articles published from January 1, 1985, to October 31, 2001. References cited in articles were used to identify potential additional articles for this review. The authors reviewed articles published in peer-reviewed scientific journals that analyzed race/ethnicity as a predictor of antiretroviral or HIV-related prophylactic medication use. RESULTS: The authors identified 28 reports, including: (a) 26 studies published in 1991-2001 that addressed antiretroviral use, spanning data collection periods from 1984 to 1999; (b) 11 studies published in 1994-2001 that addressed prophylaxis for Pneumocystis carinii pneumonia (PCP), reporting on data collected from 1989 to 1998; and (c) three studies published from 1998 to 2001 that addressed prophylaxis for other opportunistic infections, reporting on data collected from 1993 to 1998. Among the studies that addressed antiretroviral use, 14 found a negative association between non-white race and at least one measure of antiretroviral use, three studies found a positive association, and 16 studies found no association; seven studies found mixed results across several measures of antiretroviral use. Only four of 11 studies found a negative association between race/ethnicity and PCP prophylaxis; the remainder found no association. Two out of three studies found a negative association between race/ethnicity and prophylaxis for other infections. CONCLUSIONS: There is evidence of racial/ethnic disparities in utilization of antiretrovirals, which are known to be strongly associated with positive HIV health outcomes. It is now imperative for researchers and policy makers to better understand the causes of these disparities, evaluate programs that affect the delivery of HIV medications, and implement program and policy changes necessary to address the disparities.
OBJECTIVE: The authors performed a systematic and critical review of published studies investigating potential associations between race and/or ethnicity and use of HIV-related medications, including antiretroviral medications and medications used for prophylaxis of opportunistic infections. METHODS: The authors conducted a Web-based search of the University of California MEDLINE/HealthSTAR database for articles published from January 1, 1985, to October 31, 2001. References cited in articles were used to identify potential additional articles for this review. The authors reviewed articles published in peer-reviewed scientific journals that analyzed race/ethnicity as a predictor of antiretroviral or HIV-related prophylactic medication use. RESULTS: The authors identified 28 reports, including: (a) 26 studies published in 1991-2001 that addressed antiretroviral use, spanning data collection periods from 1984 to 1999; (b) 11 studies published in 1994-2001 that addressed prophylaxis for Pneumocystis carinii pneumonia (PCP), reporting on data collected from 1989 to 1998; and (c) three studies published from 1998 to 2001 that addressed prophylaxis for other opportunistic infections, reporting on data collected from 1993 to 1998. Among the studies that addressed antiretroviral use, 14 found a negative association between non-white race and at least one measure of antiretroviral use, three studies found a positive association, and 16 studies found no association; seven studies found mixed results across several measures of antiretroviral use. Only four of 11 studies found a negative association between race/ethnicity and PCP prophylaxis; the remainder found no association. Two out of three studies found a negative association between race/ethnicity and prophylaxis for other infections. CONCLUSIONS: There is evidence of racial/ethnic disparities in utilization of antiretrovirals, which are known to be strongly associated with positive HIV health outcomes. It is now imperative for researchers and policy makers to better understand the causes of these disparities, evaluate programs that affect the delivery of HIV medications, and implement program and policy changes necessary to address the disparities.
Authors: Jennifer N Sayles; Jacqueline Rurangirwa; Min Kim; Janni Kinsler; Rangell Oruga; Mike Janson Journal: AIDS Patient Care STDS Date: 2012-07-09 Impact factor: 5.078
Authors: Scott L Letendre; Jennifer Marquie-Beck; Ronald J Ellis; Steven Paul Woods; Brookie Best; David B Clifford; Ann C Collier; Benjamin B Gelman; Christina Marra; Justin C McArthur; J Allen McCutchan; Susan Morgello; David Simpson; Terry J Alexander; Janis Durelle; Robert Heaton; Igor Grant Journal: J Neuroimmune Pharmacol Date: 2007-01-03 Impact factor: 4.147
Authors: Junling Wang; Ilene H Zuckerman; Nancy A Miller; Fadia T Shaya; Jason M Noel; C Daniel Mullins Journal: Health Serv Res Date: 2007-08 Impact factor: 3.402
Authors: George Rust; George E Fryer; Robert L Phillips; Elvan Daniels; Harry Strothers; David Satcher Journal: J Natl Med Assoc Date: 2004-09 Impact factor: 1.798
Authors: Michael J Mugavero; Hui-Yi Lin; Jeroan J Allison; Thomas P Giordano; James H Willig; James L Raper; Nelda P Wray; Stephen R Cole; Joseph E Schumacher; Susan Davies; Michael S Saag Journal: J Acquir Immune Defic Syndr Date: 2009-01-01 Impact factor: 3.731