Department of Health Policy, George Washington University, Washington, DC 20006, USA.
Am J Public Health. 2010 Aug;100(8):1493-9. doi: 10.2105/AJPH.2008.158949. Epub 2009 Nov 12.
We examined racial/ethnic disparities in highly active antiretroviral therapy (HAART) use and whether differences are moderated by substance use or insurance status, using data from the Women's Interagency HIV Study (WIHS).
Logistic regression examined HAART use in a longitudinal cohort of women for whom HAART was clinically indicated in 2005 (N = 1354).
Approximately 3 of every 10 eligible women reported not taking HAART. African American and Hispanic women were less likely than were White women to use HAART. After we adjusted for potential confounders, the higher likelihood of not using HAART persisted for African American but not for Hispanic women. Uninsured and privately insured women, regardless of race/ethnicity, were less likely than were Medicaid enrollees to use HAART. Although alcohol use was related to HAART nonuse, illicit drug use was not.
These findings suggest that expanding and improving insurance coverage should increase access to antiretroviral therapy across racial/ethnic groups, but it is not likely to eliminate the disparity in use of HAART between African American and White women with HIV/AIDS.
我们利用妇女艾滋病研究机构（WIHS）的数据，研究了在接受高效抗逆转录病毒治疗（HAART）方面的种族/民族差异，以及这些差异是否因物质使用或保险状况而有所不同。
采用逻辑回归，对 2005 年 HAART 临床适用的妇女进行了纵向队列研究（N=1354）。
大约每 10 名符合条件的女性中就有 3 名报告未服用 HAART。与白人女性相比，非裔美国女性和西班牙裔女性使用 HAART 的可能性较小。在调整了潜在混杂因素后，非裔美国女性不使用 HAART 的可能性仍然较高，但西班牙裔女性则不然。无论种族/民族如何，未参保和私人参保的女性使用 HAART 的可能性均低于医疗补助计划的参保者。尽管饮酒与不使用 HAART 有关，但非法药物使用则不然。
这些发现表明，扩大和改善保险覆盖范围应能增加艾滋病毒/艾滋病患者接受抗逆转录病毒治疗的机会，但不太可能消除非裔美国人和白人女性在使用 HAART 方面的差异。
