Researchers report that racial disparities in HIV control (viral load) exist even when patients have equal access to care. This was stressed by a study of black and white HIV-infected patients treated in the Veterans Administration (VA) health system, where it was identified that specific factors contributed to these differences; the study is published in AIDS Patient Care and STDs, a peer-reviewed journal from Mary Ann Liebert Inc., and is available on the AIDS Patient Care and STDs website.
In “Patient and Facility Correlates of Racial Differences in Viral Control for Black and White Veterans with HIV Infection in the Veterans Administration” – coauthored by Mary Vaughan Sarrazin, PhD, Iowa City VA Medical Center and University of Iowa (Iowa City) and colleagues from VA Palo Alto Health Care System (CA), Stanford University (CA), ENRM Veterans Affairs Medical Center (Bedford, MA), and Boston University School of Public Health (MA) – it was determined that more than half of the disparity in viral control between black and white veterans could be attributed to differences in adherence to combination antiretroviral therapy (cART).
“This is an especially critical issue given the widening disparity in incidence of new HIV infections between African Americans and other racial/ethnic groups,” said editor in chief Jeffrey Laurence, MD, Professor of Medicine, Weill Cornell Medical College, New York, NY.
Though a comparison of the experiences of people living with HIV in non-Western countries is not included here, the researchers – nonetheless – stated that “even in this era of effective antiretroviral treatment for HIV, disparities in HIV control persist …”, and this is unfortunate because “viral control is an intermediate outcome of therapy that is tightly linked to long-term outcomes, including survival.”
And so the researchers recommended that “efforts to reduce racial disparities in care should focus on interventions to improve antiretroviral adherence and target quality improvement efforts to reduce variation in viral control across care sites.”