Disparities in antiretroviral prescribing for blacks and whites in the United States

Christine U. Oramasionwu, Jeff Skinner, Laurajo Ryan, Christopher R. Frei

    Research output: Contribution to journalArticle

    6 Scopus citations

    Abstract

    Purpose: The health benefits for blacks on highly active antiretroviral therapy (HAART) lags behind that of whites. We therefore investigated whether this discrepancy in health outcomes is attributable to disparities in the receipt of appropriate HAART between black and white human immunodeficiency virus (HIV) patients. Methods: The 2000-2005 National Ambulatory Medical Care Surveys were used to identify patients receiving antiretrovirals. Regimens were evaluated for appropriateness according to national antiretroviral guideline recommendations. A multivariable logistic regression model was used to assess black race as a predictor for appropriate HAART. Results: An estimated 4.1 million HIV-related visits with antiretroviral therapy were identified. Eighty-six percent of visits were associated with appropriate therapy; inappropriate therapy was often due to antiretroviral monotherapy. Interestingly, blacks were more likely to receive appropriate therapy in comparison to white patients (94% vs 83%, P < .001). Multivariable analysis revealed black race as an independent predictor for an appropriate regimen (χ2 likelihood ratio, 12.3, P < .001) when controlling for age, gender, insurance status, and geographic region. Conclusions: Health outcome disparities between black and white HIV patients do not appear to be attributable to differences in receipt of appropriate HAART. Further investigations are warranted to identify factors responsible for these outcome disparities.

    Original languageEnglish (US)
    Pages (from-to)1140-1148
    Number of pages9
    JournalJournal of the National Medical Association
    Volume101
    Issue number11
    Publication statusPublished - Nov 2009

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    Keywords

    • HIV/AIDS
    • Health disparities

    ASJC Scopus subject areas

    • Medicine(all)

    Cite this

    Oramasionwu, C. U., Skinner, J., Ryan, L., & Frei, C. R. (2009). Disparities in antiretroviral prescribing for blacks and whites in the United States. Journal of the National Medical Association, 101(11), 1140-1148.