Trends in Racial and Ethnic Disparities in Antiretroviral Therapy Prescription and Viral Suppression in the United States, 2009-2013.
Trends in Racial and Ethnic Disparities in Antiretroviral Therapy Prescription and Viral Suppression in the United States, 2009-2013.
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DOI：
10.1097/qai.0000000000001125
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发表时间：
2016-12-01
期刊：
影响因子：
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通讯作者：
Medical Monitoring Project
中科院分区：
文献类型：
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作者：
Beer L;Bradley H;Mattson CL;Johnson CH;Hoots B;Shouse RL;Medical Monitoring Project
研究2009年至2013年艾滋病毒感染者总体和男男性行为者在抗逆转录病毒治疗（ART）处方和病毒抑制方面的种族/族裔差异趋势。医学监测项目（MMP）是一个复杂的样本调查艾滋病毒感染的成年人接受医疗护理在美国。我们使用加权访谈和2009年6月至2014年5月收集的医疗记录数据来估计ART处方和病毒抑制在种族/民族群体和男男性行为者（MSM）中的流行程度。我们发现，从2009年到2013年，所有种族/族裔群体的抗逆转录病毒治疗处方和病毒抑制都有显著增加，无论是总体上还是在男男性行为者中。到2013年，总体上以及MSM中，在ART处方方面，西班牙裔白人之间的差异已经不存在，在考虑了黑人和白人在年龄和HIV诊断时间上的差异后，黑人和白人之间的差异并不显著。尽管在一段时间内，病毒抑制的种族/民族差异有所减少，但在总人口中仍然存在显著差异，即使在调整了种族/民族群体特征的差异之后。然而，令人鼓舞的是，到2013年，在男男性接触者中，西班牙裔和白人在病毒抑制方面没有明显的差异。尽管近年来在抗逆转录病毒治疗处方和病毒抑制方面取得了重大进展，但种族和民族差异仍然存在，特别是对黑人而言。如果美国要实现减少与艾滋病毒有关的健康差距的国家艾滋病毒/艾滋病战略目标，可能需要优先考虑继续努力加快改善抗逆转录病毒治疗处方的速度，并在西班牙裔和黑人中抑制病毒。
To examine trends in racial/ethnic disparities in antiretroviral therapy (ART) prescription and viral suppression among HIV-infected persons in care, overall and among MSM, from 2009 to 2013. The Medical Monitoring Project (MMP) is a complex sample survey of HIV-infected adults receiving medical care in the United States. We used weighted interview and medical record data collected 06/2009–05/2014 to estimate the prevalence of ART prescription and viral suppression among racial/ethnic groups overall and among men who have sex with men (MSM). We found significant increases in ART prescription and viral suppression among all racial/ethnic groups from 2009 to 2013, both overall and among MSM. By 2013, overall and among MSM, the Hispanic-white disparity in ART prescription was non-existent, and the black-white disparity was not significant after accounting for differences between blacks and whites in age and length of HIV diagnosis. Despite reductions in racial/ethnic disparities in viral suppression over the time period, significant disparities remained among the total population, even after adjusting for differences in racial/ethnic group characteristics. Encouragingly, however, there was no significant Hispanic-white disparity in viral suppression among MSM by 2013. Despite significant improvements in ART prescription and viral suppression in recent years, racial and ethnic disparities persist, particularly for black persons. If the United States is to achieve the National HIV/AIDS Strategy goal of reducing HIV-related health disparities, continued efforts to accelerate the rate of improvement in ART prescription and viral suppression among Hispanic and black persons may need to be prioritized.