Gillings School of Global Public Health.
School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC.
AIDS. 2021 Jul 1;35(8):1229-1239. doi: 10.1097/QAD.0000000000002876.
To examine recent trends and differences in all-cause and cause-specific hospitalization rates by race, ethnicity, and gender among persons with HIV (PWH) in the United States and Canada.
HIV clinical cohort consortium.
We followed PWH at least 18 years old in care 2005-2015 in six clinical cohorts. We used modified Clinical Classifications Software to categorize hospital discharge diagnoses. Incidence rate ratios (IRR) were estimated using Poisson regression with robust variances to compare racial and ethnic groups, stratified by gender, adjusted for cohort, calendar year, injection drug use history, and annually updated age, CD4+, and HIV viral load.
Among 27 085 patients (122 566 person-years), 80% were cisgender men, 1% transgender, 43% White, 33% Black, 17% Hispanic of any race, and 1% Indigenous. Unadjusted all-cause hospitalization rates were higher for Black [IRR 1.46, 95% confidence interval (CI) 1.32-1.61] and Indigenous (1.99, 1.44-2.74) versus White cisgender men, and for Indigenous versus White cisgender women (2.55, 1.68-3.89). Unadjusted AIDS-related hospitalization rates were also higher for Black, Hispanic, and Indigenous versus White cisgender men (all P < 0.05). Transgender patients had 1.50 times (1.05-2.14) and cisgender women 1.37 times (1.26-1.48) the unadjusted hospitalization rate of cisgender men. In adjusted analyses, among both cisgender men and women, Black patients had higher rates of cardiovascular and renal/genitourinary hospitalizations compared to Whites (all P < 0.05).
Black, Hispanic, Indigenous, women, and transgender PWH in the United States and Canada experienced substantially higher hospitalization rates than White patients and cisgender men, respectively. Disparities likely have several causes, including differences in virologic suppression and chronic conditions such as diabetes and renal disease.
在美国和加拿大，检查 2005-2015 年间所有原因和特定原因住院率的最新趋势和差异，按种族、民族和性别划分艾滋病毒感染者（PWH）。
艾滋病毒临床队列联盟。
我们在六个临床队列中，对至少 18 岁接受护理的 PWH 进行了随访。我们使用改良临床分类软件对出院诊断进行分类。使用泊松回归估计发病率比（IRR），采用稳健方差进行比较，按性别分层，调整队列、日历年份、注射毒品史以及每年更新的年龄、CD4+和 HIV 病毒载量。
在 27085 名患者（122566 人年）中，80%为顺性别男性，1%为跨性别者，43%为白人，33%为黑人，17%为任何种族的西班牙裔，1%为土著人。未经调整的全因住院率黑人[IRR 1.46，95%置信区间（CI）1.32-1.61]和土著人（1.99，1.44-2.74）高于白人顺性别男性，而土著人高于白人顺性别女性（2.55，1.68-3.89）。未经调整的艾滋病相关住院率黑人、西班牙裔和土著人也高于白人顺性别男性（均 P<0.05）。跨性别患者的住院率是顺性别男性的 1.50 倍（1.05-2.14），顺性别女性的住院率是顺性别男性的 1.37 倍（1.26-1.48）。在调整分析中，在顺性别男性和女性中，与白人相比，黑人患者心血管和肾脏/生殖泌尿系统住院率更高（均 P<0.05）。
在美国和加拿大，黑人、西班牙裔、土著人、女性和跨性别 PWH 的住院率明显高于白人患者和顺性别男性，分别。差异可能有多种原因，包括病毒抑制和糖尿病和肾脏疾病等慢性疾病的差异。
