02 Oct Among HIV Patients, Black Women Have Highest Rates of Premature Mortality
MedicalResearch.com Interview with:
Rachael Pellegrino, MD
Vanderbilt University Medical Center
MedicalResearch.com: What is the background for this study?
Response: We know that HIV care and outcomes have dramatically improved over the last 20 years, but disparities still exist at each step of the HIV care continuum, which can ultimately lead to differences in mortality rates. In addition to assessing trends and disparities in mortality, we wanted to look at differences in premature mortality, which has not been widely studied in the HIV population in the US. This concept serves to emphasize and quantify the time lost by death at an early age as an important measurement of the impact of diseases and can expose disparities that are not apparent in the mortality rates alone.
MedicalResearch.com: What are the main findings?
Response: Our main findings were that individuals with HIV in the most recent calendar era (2014-2018) had a 73% decreased risk of mortality compared to the earliest calendar era (1998-2003).
Secondly, women were found to have significantly higher mortality and premature mortality compared to men when we accounted for factors such as year, age, race, and HIV disease stage at clinic entry.
And lastly, while Black individuals did not have significantly higher mortality rates, they were found to have higher rates of premature mortality and these rates were highest in Black women.
MedicalResearch.com: What should readers take away from your report?
Response: Some key takeaways are that declines in mortality rates from 1998 to 2018 highlight the national improvements in HIV care, but we still see disparities in mortality of individuals with HIV, especially in women. When looking closer at premature mortality, we see higher rates in women and specifically black women. A focus on improving these disparities will need to be tied closely with addressing the social determinants of health that create and reinforce these inequities.
MedicalResearch.com: What recommendations do you have for future research as a result of this work?
Response: With our cohort, we were unable to assess the changes in premature mortality over time due to sample size and we were unable to factor in additional social determinants of health which were not available in our dataset. Both analyses would be important additions to this conversation and could lead to more directed interventions.
We have no disclosures.
Citation: Abstract presented at ID Week 2021
Sex and Race Disparities in Premature Mortality among People with HIV: A 21-Year Observational Cohort Study
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