Effect of race and/or ethnicity in use of antiretrovirals and prophylaxis for opportunistic infection: a review of the literature

Palacio, Herminia; Kahn, James G.; Richards, T. Anne; Morin, Stephen F.

doi:10.1016/s0033-3549(04)50158-9

Cited by 77 publications

(28 citation statements)

References 41 publications

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“…Racial/ethnic disparities in the quality of HIV care have been widely documented [1–4]. Minority patients with HIV/AIDS, especially African Americans, receive antiretroviral therapy (ART) less frequently than white patients do [5], receive ART for a shorter period of time [6], and have lower ART adherence [7–10].…”

Section: Introductionmentioning

confidence: 99%

The role of cultural distance between patient and provider in explaining racial/ethnic disparities in HIV care

Saha¹,

Sanders²,

Korthuis³

et al. 2011

Patient Education and Counseling

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Objective We sought to evaluate whether cultural distance between patients and providers was associated with quality of care for people living with HIV/AIDS, and whether cultural distance helped explain racial/ethnic disparities in HIV care. Methods We surveyed 437 patients and 45 providers at 4 HIV clinics in the U.S. We examined the association of patients' perceived cultural distance from their providers with patient ratings of healthcare quality, trust in provider, receipt of antiretroviral therapy, medication adherence, and viral suppression. We also examined whether racial/ethnic disparities in these aspects of HIV care were mediated by cultural distance. Results Greater cultural distance was associated with lower patient ratings of healthcare quality and less trust in providers. Compared to white patients, nonwhites had significantly lower levels of trust, adherence, and viral suppression. Adjusting for patient-provider cultural distance did not significantly affect any of these disparities (p-values for mediation >.10). Conclusion Patient-provider cultural distance was negatively associated with perceived quality of care and trust but did not explain racial/ethnic disparities in HIV care. Practice implications Bridging cultural differences may improve patient–provider relationships but may have limited impact in reducing racial/ethnic disparities, unless coupled with efforts to address other sources of unequal care.

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Section: Introductionmentioning

confidence: 99%

The role of cultural distance between patient and provider in explaining racial/ethnic disparities in HIV care

Saha¹,

Sanders²,

Korthuis³

et al. 2011

Patient Education and Counseling

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show abstract

“…To assess use of antiretrovirals, we explored the utilization of HAART among program enrollees. Companion articles from our project provide a comprehensive literature review, 10 describe patient and provider perceptions regarding programs and antiretroviral therapy, 17 and assess state and federal policy issues and implications. 18 …”

mentioning

confidence: 99%

Access to and Use of HIV Antiretroviral Therapy: Variation by Race/Ethnicity in Two Public Insurance Programs in the U.S.

Kahn

Zhang²,

Cross³

et al. 2002

Public Health Reports

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SYNOPSISObjectives. To examine access to and use of HIV highly active antiretroviral therapy (HAART) by race/ethnicity in Medicaid and the AIDS Drug Assistance Program (ADAP) in 1998 in four states.Methods. The authors analyzed reimbursement claims and AIDS surveillance data in California, Florida, New York, and Texas. Study subjects were identified using diagnostic or medication codes specific to HIV. The race/ethnicity of program enrollees was compared to representation in the HIV epidemic to examine access. Claims for antiretroviral (ARV) use were compared to U.S. Public Health Service treatment guidelines to assess HAART use.Results. The authors identified 151,000 HIV-infected individuals in these two programs in the four states. Evidence of AIDS or symptomatic HIV was present in 78%-88% of enrollees in Medicaid, versus 31%-48% in ADAP. African Americans participated in Medicaid 10%-53% above and in ADAP 17%-31% below representation in the epidemic. Non-Latino whites exhibited the opposite pattern, being in Medicaid 5%-38% below and in ADAP 9%-65% above epidemic representation. Latinos participated more in ADAP (7%-31%), except in New York. HAART use over 90 days (July-September) ranged from 38% to 76% by program and state. Differences by race/ethnicity were inconsistent and small: African Americans had lower HAART use by 6%-14% in California and Florida Medicaid, and Latinos had higher HAART use by 2%-11% in ADAP and in Texas Medicaid.Conclusions. African Americans were more likely to access HIV drugs through Medicaid than through ADAP, which may reflect differences in program eligibility criteria as well as care seeking later in HIV disease. Differences in the use of HAART by race/ethnicity within state programs were small.

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“…Researchers have explained the particularly poor outcomes for African Americans living with HIV in terms of delays in accessing care and difficulties in accessing and adhering to medication regimens (Cohen et al, 2007; Kahn et al, 2002; Siegel, Karus, & Schrimshaw, 2000). Studies have shown that African Americans living with HIV do not remain in care, access treatment later, and adhere to medications less well than other people living with HIV (Kahn, et al, 2002; Kempf et al, 2010; Palacio, Kahn, Richards, & Morin, 2002). …”

Section: Introductionmentioning

confidence: 99%

Assessing stigma among African Americans living with HIV.

Rao¹,

Molina²,

Lambert³

et al. 2016

Stigma and Health

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Purpose In the present study, we validated a culturally adapted stigma scale designed to assess stigma among African Americans living with HIV. Methods We collected data on the scale using an audio computer assisted self-interview (ACASI) format. We validated the scale with a sample of 62 African American participants living with HIV. Results Findings demonstrated that stigma can be measured succinctly and effectively in a 14-item scale with two subscales measuring enacted and internalized stigma. Discussion We identified many advantages to using the scale, which demonstrated good psychometric properties when used with an audio computer assisted self-interview format and with an African American sample. We recommend this scale’s use in both clinical practice and research study of HIV-stigma reduction interventions with African American populations.

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Effect of race and/or ethnicity in use of antiretrovirals and prophylaxis for opportunistic infection: a review of the literature

Cited by 77 publications

References 41 publications

The role of cultural distance between patient and provider in explaining racial/ethnic disparities in HIV care

The role of cultural distance between patient and provider in explaining racial/ethnic disparities in HIV care

Access to and Use of HIV Antiretroviral Therapy: Variation by Race/Ethnicity in Two Public Insurance Programs in the U.S.

Assessing stigma among African Americans living with HIV.

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