Sociostructural Correlates of AIDS Progression for African American Women Living with Diagnoses of HIV Infection in the District of Columbia

Yzette Lanier Jenevieve Opoku

doi:10.4172/2155-6113.1000254

Abstract

Background: Among women living with HIV infection in the District of Columbia (DC), African American women are disproportionately affected, comprising > 90% of reported cases. Sociostructural exploration of local HIV epidemics among African American women has been understudied. We explored sociostructural correlates of health for HIVinfected African American women in DC to inform local HIV prevention and intervention efforts. Methods: HIV surveillance data from the District of Columbia Department of Health for African American women living with HIV were reviewed. We analyzed data for sociostructural correlates for progressing to acquired immune deficiency syndrome (AIDS) (CD4 counts < 200 cells/ml) among African American women. Data were analyzed using SAS 9.2 and mapped by census tracts using ArcGIS. Results: Of 4,619 women living with HIV, 4,204 (91%) were African American; 3,050 (72.5%) had census tract information available and were included. Median age at diagnosis was 36.6 years. Among these 3,050 African American women, 1,814 (59.4%) had ever progressed to AIDS, 1,109 (36.4%) had CD4 counts < 200 cells/μl (AIDS) at most recent clinical visit, and 208 of 1,109 (18.8%) had progressed to AIDS within 12 months of their HIV diagnosis (late testers). Women who progressed to AIDS had a higher probability of being diagnosed at private facilities compared with public facilities (PR=1.1, 95% CI=1.1-1.3) and of being exposed through injection drug use (IDU) compared to being exposed through heterosexual contact (PR=1.3, 95% CI=1.2-1.5). In multivariate and geomapping analyses, poverty, education levels and census tracts were not associated with an AIDS diagnosis. Conclusion: Progression to AIDS is prevalent among HIV-infected African American women in DC. Increased, early routine HIV screening and intensified treatment efforts with African American women living with HIV infection in DC, regardless of socioeconomic status, are warranted, to improve outcomes and decrease disparities.

Highlights

Human immunodeficiency virus (HIV) in the United States (US) continues to disproportionately affect men, women are increasingly represented among persons living with human immunodeficiency virus (HIV) infection [1]
Understanding the disproportionate burden of HIV infection among African American women is vital to improving our HIV prevention efforts and is required as we work toward achieving the goals outlined in the United States’ National HIV/acquired immune deficiency syndrome (AIDS) Strategy which include: reducing HIV incidence, ensuring access to HIV treatment and care, and reducing HIV-related health disparities [3]
This study examined local and US Census and sociostructural data to describe correlates of AIDS progression among African American women living with an HIV infection in District of Columbia (DC)

Summary

Introduction

Human immunodeficiency virus (HIV) in the United States (US) continues to disproportionately affect men, women are increasingly represented among persons living with HIV infection [1]. Understanding the disproportionate burden of HIV infection among African American women is vital to improving our HIV prevention efforts and is required as we work toward achieving the goals outlined in the United States’ National HIV/AIDS Strategy which include: reducing HIV incidence, ensuring access to HIV treatment and care, and reducing HIV-related health disparities [3]. One strategy for strengthening national HIV research and prevention efforts with African American women is to understand the drivers of HIV in local, high HIV morbidity jurisdictions, like the District of Columbia. Among women living with HIV infection in the District of Columbia (DC), African American women are disproportionately affected, comprising > 90% of reported cases. We explored sociostructural correlates of health for HIVinfected African American women in DC to inform local HIV prevention and intervention efforts

Methods

Results

Conclusion