The Influence of Sex, Race/Ethnicity, and Educational Attainment on Human Immunodeficiency Virus Death Rates Among Adults, 1993-2007

Abstract

Background: Overall declines in human immunodeficiency virus (HIV) mortality may mask patterns for subgroups, and prior studies of disparities in mortality have used area-level vs individual-level socioeconomic status measures. The aim of this study was to examine temporal trends in HIV mortality by sex, race/ethnicity, and individual level of education (as a proxy for socioeconomic status).Methods: We examined HIV deaths among non-Hispanic white, non-Hispanic black, and Hispanic men and women aged 25 to 64 years in 26 states (1993-2007; N=91 307) reported to the National Vital Statistics System. The main outcome measures were age-standardized HIV death rates, rate differences, and rate ratios by educational attainment and between the least-and the mosteducated (Յ12 vs Ն16 years) individuals.

Black:White Disparities in HIV Mortality in the United States: 1990–2009

“…Literature on this topic is scant, though one study reported that even after controlling for education (a proxy for SES), Black women still had higher HIV mortality rates than White men starting in 1999. [23] As reported in the present study, Black women have experienced the slowest decline in HIV mortality and understanding why this is the case should help us determine how to address the high rates among this group.…”

“…Finally, the Black:White HIV mortality disparity resulted in 5603 excess Black deaths annually in the USA. These data demonstrate an indisputable White advantage with respect to HIV mortality, which has been occurring since at least 1990 [23,9,24,25,13].…”

“…Some portion of the racial difference in the percent prescribed ART may be accounted for by guidelines at the time which recommended ART based on disease severity [42]. And some portion of the racial difference in the percent achieving viral suppression may be accounted for by differences in either response or adherence to ART [9,13,23,40,[43][44][45][46][47][48][49][50].…”

Effects of a Laboratory Health Information Exchange Intervention on Antiretroviral Therapy Use, Viral Suppression, and Racial/Ethnic Disparities

“…1,2 Blacks have the highest incidence of HIV infections, the highest prevalence of undiagnosed HIV and the greatest mortality among racial/ethnic groups. 3-5 They are least likely to be linked to and retained in care, to receive ART, and to achieve HIV RNA VS. 6,7 Latinos are disproportionately affected, as well. The annual incidence of HIV among Latinos is approximately three times that of Whites.…”

¿Qué es primero: desigualdades o inequidades? A propósito del caso de la mortalidad por VIH/ sida en Cali, Colombia (1986-2012)

“…Para el año 2011, aquellos con mayor tasa de mortalidad por sida fueron Quindío con 15.56, Risaralda con 8.6 y Valle del Cauca con 7.9; en todos hay mayor mortalidad en hombres que en mujeres (20). En todo caso, lo que ha mostrado la literatura científica es que las desigualdades, bien sean geográficas, de género o socioeconómicas, se asocian con dificultades para el acceso a los tratamientos y la adherencia terapéutica, la aparición de comorbilidades y el mayor riesgo de mortalidad (21)(22)(23). Esto se agudiza cuando se trata de los grupos más desfavorecidos en la jerarquía social y en particular en población afrodescendiente (24).…”