Gender, sex, and HIV: how well are we addressing the imbalance?

Hankins, Catherine

doi:10.1097/coh.0b013e32830136b4

Cited by 22 publications

(17 citation statements)

References 48 publications

(31 reference statements)

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“…This result is in accordance with the global phenomenon known as the feminization of the HIV epidemic (16). According to The United Nations Joint Programme on HIV/AIDS (UNAIDS), strategies to increase women's economic independence and legal reforms to recognize women's property and inheritance rights should be prioritized by national governments to try to counter this phenomenon (1).…”

Section: Discussionsupporting

confidence: 71%

Brazilian HIV-Infected Population: Assessment of the Needs of Endodontic Treatment in the Post–Highly Active Antiretroviral Therapy Era

Brito

Rosa

Lopes

et al. 2009

Journal of Endodontics

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Section: Discussionsupporting

confidence: 71%

Brazilian HIV-Infected Population: Assessment of the Needs of Endodontic Treatment in the Post–Highly Active Antiretroviral Therapy Era

Brito

Rosa

Lopes

et al. 2009

Journal of Endodontics

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“…As women’s experiences of HIV infection and ART are unique, tailored services that respond to women’s needs are critical for improving health outcomes [25], [26]. The gender and risk associated differences in treatment outcomes demonstrated in this analysis likely reflect an interplay between structural, psychosocial, and biological factors.…”

Section: Discussionmentioning

confidence: 94%

Gender Differences in Clinical Outcomes among HIV-Positive Individuals on Antiretroviral Therapy in Canada: A Multisite Cohort Study

et al. 2013

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BackgroundCohort data examining differences by gender in clinical responses to combination antiretroviral therapy (ART) remain inconsistent and have yet to be explored in a multi-province Canadian setting. This study investigates gender differences by injection drug use (IDU) history in virologic responses to ART and mortality.MethodsData from the Canadian Observational Cohort (CANOC) collaboration, a multisite cohort study of HIV-positive individuals initiating ART after January 1, 2000, were included. This analysis was restricted to participants with a follow-up HIV-RNA plasma viral load measure and known IDU history. Weibull hazard regression evaluated time to virologic suppression (2 consecutive measures <50 copies/mL), rebound (>1000 copies/mL after suppression), and all-cause mortality. Sensitivity analyses explored the impact of presumed ART use in pregnancy on virologic outcomes.ResultsAt baseline, women (1120 of 5442 participants) were younger (median 36 vs. 41 years) and more frequently reported IDU history (43.5% vs. 28.8%) (both p<0.001). Irrespective of IDU history, in adjusted multivariable analyses women were significantly less likely to virologically suppress after ART initiation and were at increased risk of viral load rebound. In adjusted time to death analysis, no differences by gender were noted. After adjusting for presumed ART use in pregnancy, observed gender differences in time to virologic suppression for non-IDU, and time to virologic rebound for IDU, became insignificant.ConclusionsHIV-positive women in CANOC are at heightened risk for poor clinical outcomes. Further understanding of the intersections between gender and other factors augmenting risk is needed to maximize the benefits of ART.

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“…Similarly, intervention efforts should seek to involve both men and women as part of an equitable response [63,64]. These results provide useful information to support the monitoring of the epidemic, informing policy and programmatic action, and to motivate efforts to improve the effectiveness of ART implementation and uptake.…”

Section: Discussionmentioning

confidence: 99%

Patterns, trends and sex differences in HIV/AIDS reported mortality in Latin American countries: 1996-2007

et al. 2011

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BackgroundInternational cohort studies have shown that antiretroviral treatment (ART) has improved survival of HIV-infected individuals. National population based studies of HIV mortality exist in industrialized settings but few have been presented from developing countries. Our objective was to investigate on a population basis, the regional situation regarding HIV mortality and trends in Latin America (LA) in the context of adoption of public ART policies and gender differences.MethodsCause of death data from vital statistics registries from 1996 to 2007 with "good" or "average" quality of mortality data were examined. Standardized mortality rates and Poisson regression models by country were developed and differences among countries assessed to identify patterns of HIV mortality over time occurring in Latin America.ResultsStandardized HIV mortality following the adoption of public ART policies was highest in Panama and El Salvador and lowest in Chile. During the study period, three overall patterns were identified in HIV mortality trends- following the adoption of the free ART public policies; a remarkable decrement, a remarkable increment and a slight increment. HIV mortality was consistently higher in males compared to females. Mean age of death attributable to HIV increased in the majority of countries over the study period.ConclusionsVital statistics registries provide valuable information on HIV mortality in LA. While the introduction of national policies for free ART provision has coincided with declines in population-level HIV mortality and increasing age of death in some countries, in others HIV mortality has increased. Barriers to effective ART implementation and uptake in the context of free ART public provision policies should be further investigated.

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Gender, sex, and HIV: how well are we addressing the imbalance?

Cited by 22 publications

References 48 publications

Brazilian HIV-Infected Population: Assessment of the Needs of Endodontic Treatment in the Post–Highly Active Antiretroviral Therapy Era

Brazilian HIV-Infected Population: Assessment of the Needs of Endodontic Treatment in the Post–Highly Active Antiretroviral Therapy Era

Gender Differences in Clinical Outcomes among HIV-Positive Individuals on Antiretroviral Therapy in Canada: A Multisite Cohort Study

Patterns, trends and sex differences in HIV/AIDS reported mortality in Latin American countries: 1996-2007

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