Division of HIV/AIDS Prevention, National Centers for HIV, Viral Hepatitis, STD and TB Prevention, Centers for Disease Control and Prevention, Atlanta, GA.
J Acquir Immune Defic Syndr. 2018 Oct 1;79(2):e56-e68. doi: 10.1097/QAI.0000000000001779.
Women with HIV diagnoses are less likely to be virally suppressed than men. Women of different racial/ethnic groups may be differentially affected by sociodemographic factors. We examined differences in viral suppression among women by race/ethnicity and associated variables to inform prevention interventions.
We used data from the 2010-2014 cycles of the Medical Monitoring Project, a cross-sectional survey of HIV-positive adults in care. We limited analyses to black, Hispanic, and white women. We calculated weighted prevalences of recent viral suppression (undetectable or <200 copies/mL) and sustained viral suppression (consistent viral suppression during the past 12 months) among women by race/ethnicity. We computed adjusted prevalence differences (aPDs) and 95% confidence intervals (CIs) for viral suppression by racial/ethnic group, controlling for selected variables, including available social determinants of health variables.
Among women, 62.9% were black, 19.8% Hispanic, and 17.3% white. Overall, 74.3% had recent viral suppression, and 62.3% had sustained viral suppression. Compared with white women (79.7%, CI: 77.2 to 82.2), black (72.5%, CI: 70.3 to 74.7; PD: 7.2) and Hispanic (75.4%, CI: 72.6 to 78.3; PD: 4.3) women were less likely to have recent viral suppression. In multivariable analyses, after adjusting for antiretroviral therapy adherence, HIV disease stage, age, homelessness, and education, black-white aPDs remained significant for recent (aPD: 4.8, CI: 1.6 to 8.1) and sustained (aPD: 5.0, CI: 1.1 to 9.0) viral suppression.
Viral suppression was suboptimal for all women, but more for black and Hispanic women. Differences between black, Hispanic, and white women may be partially due to antiretroviral therapy adherence, HIV disease stage, and social determinants of health factors.
与男性相比，HIV 诊断女性病毒抑制率较低。不同种族/族裔的女性可能受到社会人口因素的不同影响。我们研究了种族/族裔差异对女性病毒抑制的影响，并对相关变量进行了分析，以指导预防干预。
我们使用了 2010-2014 年医疗监测项目的数据，这是一项针对接受治疗的 HIV 阳性成年人的横断面调查。我们将分析仅限于黑人、西班牙裔和白人女性。我们计算了不同种族/族裔女性最近病毒抑制（无法检测或<200 拷贝/ml）和持续病毒抑制（过去 12 个月内持续病毒抑制）的加权流行率。我们计算了病毒抑制的调整流行率差异（aPD）和 95%置信区间（CI），按种族/族裔组进行比较，控制了一些选定变量，包括可用的社会决定健康变量。
在女性中，62.9%为黑人，19.8%为西班牙裔，17.3%为白人。总体而言，74.3%的女性最近病毒抑制，62.3%的女性持续病毒抑制。与白人女性（79.7%，CI：77.2%至 82.2%）相比，黑人（72.5%，CI：70.3%至 74.7%；PD：7.2%）和西班牙裔（75.4%，CI：72.6%至 78.3%；PD：4.3%）女性最近病毒抑制的可能性较小。在多变量分析中，调整抗逆转录病毒治疗依从性、HIV 疾病分期、年龄、无家可归和教育后，黑人-白人最近（aPD：4.8，CI：1.6 至 8.1）和持续（aPD：5.0，CI：1.1 至 9.0）病毒抑制的 aPD 仍然显著。
所有女性的病毒抑制都不理想，但黑人女性和西班牙裔女性的情况更差。黑人、西班牙裔和白人女性之间的差异可能部分归因于抗逆转录病毒治疗的依从性、HIV 疾病分期和社会决定健康因素。
