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2009 - 2013年美国抗逆转录病毒疗法处方及病毒抑制方面的种族和族裔差异趋势

Trends in Racial and Ethnic Disparities in Antiretroviral Therapy Prescription and Viral Suppression in the United States, 2009-2013.

作者信息

Beer Linda, Bradley Heather, Mattson Christine L, Johnson Christopher H, Hoots Brooke, Shouse Roy L

机构信息

Division of HIV/AIDS Prevention, Centers for Disease Control and Prevention, Atlanta, GA.

出版信息

J Acquir Immune Defic Syndr. 2016 Dec 1;73(4):446-453. doi: 10.1097/QAI.0000000000001125.

Abstract

OBJECTIVES

To examine trends in racial/ethnic disparities in antiretroviral therapy (ART) prescription and viral suppression among HIV-infected persons in care, overall and among men who have sex with men (MSM), from 2009 to 2013.

DESIGN

The Medical Monitoring Project (MMP) is a complex sample survey of HIV-infected adults receiving medical care in the United States.

METHODS

We used weighted interview and medical record data collected June 2009-May 2014 to estimate the prevalence of ART prescription and viral suppression among racial/ethnic groups overall and among MSM.

RESULTS

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 nonexistent, 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.

CONCLUSIONS

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.

摘要

目的

研究2009年至2013年期间,接受治疗的HIV感染者中,总体以及男男性行为者(MSM)中抗逆转录病毒疗法(ART)处方和病毒抑制方面的种族/族裔差异趋势。

设计

医疗监测项目(MMP)是一项针对在美国接受医疗护理的HIV感染成年人的复杂抽样调查。

方法

我们使用了2009年6月至2014年5月收集的加权访谈和医疗记录数据,以估计总体种族/族裔群体以及MSM中ART处方和病毒抑制的患病率。

结果

我们发现,2009年至2013年期间,所有种族/族裔群体在总体以及MSM中,ART处方和病毒抑制都有显著增加。到2013年,总体以及MSM中,西班牙裔与白人在ART处方方面的差异不存在了,在考虑了黑人和白人在年龄和HIV诊断时长方面的差异后,黑人和白人之间的差异也不显著。尽管在此期间病毒抑制方面的种族/族裔差异有所减少,但即使在调整了种族/族裔群体特征差异后,总体人群中仍存在显著差异。然而,令人鼓舞的是,到2013年,MSM中西班牙裔与白人在病毒抑制方面没有显著差异。

结论

尽管近年来ART处方和病毒抑制有显著改善,但种族和族裔差异仍然存在,尤其是黑人。如果美国要实现减少与HIV相关的健康差异的国家HIV/AIDS战略目标,可能需要优先继续努力加快西班牙裔和黑人在ART处方和病毒抑制方面的改善速度。

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