Dehghani Firouzabadi Ali, McDonald Tiffany C, Samms Tametria R, Sirous Reza, Johnson Kendra
Mississippi State Department of Health, Office of STD/HIV, 570 E. Woodrow Wilson, Osborne 200, Jackson, MS 39216, USA.
University of Mississippi Medical Center, 2500 N State St, Jackson, MS 39216, USA.
Int J Environ Res Public Health. 2017 Apr 7;14(4):392. doi: 10.3390/ijerph14040392.
Increasing patients' cluster of differentiation 4 (CD4) count and achieving viral suppression are the ultimate goals of the human immunodeficiency virus (HIV) care and treatment, yet disparities in these HIV clinical outcomes exist among subpopulations of HIV-infected persons. We aimed to assess potential disparities in viral suppression and normal CD4 count among HIV-infected persons receiving care in Mississippi using Mississippi Medical Monitoring Project (MMP) data from 2009 to 2014 ( = 1233) in this study. Outcome variables in this study were suppressed, recent and durable viral load, and normal CD4 count. Patients' characteristics in this study were race, gender, age, annual income, education, insurance, and length of diagnosis. Descriptive statistics, Chi square tests, and logistic regression analyses were conducted using the SAS 9.4 Proc Survey procedure. Our findings indicate that those aged 50 years or older were more likely to have suppressed recent viral load (adjusted Odds Ratio (aOR) = 2.4) and durable viral loads (aOR = 2.9), compared to those aged 18-24 years. In addition, women were more likely to have a normal CD4 count than men (aOR = 1.4). In conclusion, we found that age and gender disparities in HIV clinical outcomes may be used to develop and implement multifaceted interventions to improve health equity among all HIV-infected patients.
提高患者的分化簇4(CD4)计数并实现病毒抑制是人类免疫缺陷病毒(HIV)护理和治疗的最终目标,但在HIV感染者的亚群体中,这些HIV临床结果存在差异。在本研究中,我们旨在利用2009年至2014年密西西比州医疗监测项目(MMP)的数据(n = 1233)评估在密西西比州接受护理的HIV感染者中病毒抑制和正常CD4计数的潜在差异。本研究的结果变量为病毒载量被抑制、近期和持久病毒载量以及正常CD4计数。本研究中患者的特征包括种族、性别、年龄、年收入、教育程度、保险和诊断时长。使用SAS 9.4 Proc Survey程序进行描述性统计、卡方检验和逻辑回归分析。我们的研究结果表明,与18 - 24岁的人相比,50岁及以上的人近期病毒载量被抑制(调整后的优势比(aOR)= 2.4)和持久病毒载量(aOR = 2.9)的可能性更高。此外,女性CD4计数正常的可能性高于男性(aOR = 1.4)。总之,我们发现HIV临床结果中的年龄和性别差异可用于制定和实施多方面干预措施,以改善所有HIV感染者的健康公平性。