Black Mortality from HIV Declines But Still Higher Than Whites, Hispanics

MedicalResearch.com Interview with:
Azfar-e-Alam Siddiqi, MD, PhD
Associate Chief of Science (Acting)
HIV Incidence and Case Surveillance Branch
Division of HIV/AIDS Prevention
National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention
Centers for Disease Control and Prevention

Medical Research: What is the background for this study? What are the main findings?

Dr. Sidiqqi: African Americans remain the population most affected by HIV in the United States — accounting for almost half (44 percent) of all new infections and more than a third (41 percent) of people living with HIV, despite representing just 12 percent of the U.S. population. We also know that far too many African Americans living with HIV do not get the medical care and treatment they need to stay healthy and protect themselves and others. In fact, less than half (40 percent) of African Americans living with HIV are engaged in care and only one-quarter (28 percent) have the virus under control through treatment.

To better understand mortality among African Americans with HIV, our team analyzed data from the National HIV Surveillance System for 2008 through 2012. Because immune suppression caused by HIV infection can result in fatal co-illnesses, our analysis estimated deaths due to all causes, rather than limiting their analysis to deaths resulting directly from HIV infection. This method allowed us to capture the fullest picture of mortality among African Americans with HIV.

According to our new analysis, from 2008-2012, the death rate per 1,000 blacks living with HIV decreased 28 percent, more than the overall decline (22 percent) observed among all persons living with HIV and more than declines observed among other races/ethnicities (13 percent for whites and 25 percent for Hispanics). Despite substantial declines in mortality, the death rate per 1,000 blacks living with HIV in 2012 was 13 percent higher than the rate for whites and 47 percent higher than the rate for Hispanics.

Medical Research: What should clinicians and patients take away from your report?

Dr. Sidiqqi: To build on the progress we’ve already made and, one day, realize a future without HIV and AIDS, we will have to confront this  disease head on. Each of us has a critical role to play.

Individuals can start by getting tested. We need to ensure all people living with HIV know they are infected. But, getting tested is just the first step – getting into – and staying in – appropriate care and taking steps to prevent further transmission are also critical. People who have HIV need to receive HIV treatment – it can help them live longer, healthier lives, and recent studies have shown that it can dramatically reduce HIV transmission. People who don’t have HIV should talk to their healthcare provider about all of the prevention options available today, such as daily pre-exposure prophylaxis.

Healthcare providers should test their patients for HIV according to CDC recommendations, talk with their patients who may be at risk for infection about available prevention options, and work closely with their patients who have HIV to be sure they’re continuing to receive the treatment they need, as well as risk reduction counseling on how to protect their partners.

Medical Research: What recommendations do you have for future research as a result of this study?

Dr. Sidiqqi: Continuing to track trends in mortality moving forward would allow us to monitor progress. Additionally, research into ways to successfully engage people with HIV in care and to keep them on medication will have far-reaching consequences.

Citation: 

Mortality Among Blacks or African Americans with HIV Infection — United States, 2008–2012

MMWR Weekly February6 2015