Community poverty and trends in racial/ethnic survival disparities among people diagnosed with AIDS in Florida, 1993-2004

M.J. Trepka, T. Niyonsenga, L. Maddox, S. Lieb, K. Lutfi and E. Pavlova-McCalla

American Journal of Public Health, 2013, vol. 103, issue 4, 717-726

Abstract: Objectives: We described the racial/ethnic disparities in survival among people diagnosed with AIDS in Florida from 1993 to 2004, as the availability of highly active antiretroviral therapy (HAART) became widespread. We determined whether these disparities decreased after controlling for measures of community-level socioeconomic status. Methods: We compared survival from all causes between non-Hispanic Blacks and non-Hispanic Whites vis-a-vis survival curves and Cox proportional hazards models controlling for demographic, clinical, and area-level poverty factors. Results: Racial/ethnic disparities in survival peaked for those diagnosed during the early implementation of HAART (1996-1998) with a Black-to-White hazard ratio (HR) of 1.72 (95% confidence interval [CI] = 1.62, 1.83) for males and 1.40 (95% CI = 1.24, 1.59) for females. These HRs declined significantly to 1.48 (95% CI = 1.35, 1.64) for males and nonsignificantly to 1.25 (95% CI = 1.05, 1.48) for females in the 2002 to 2004 diagnosis cohort. Disparities decreased significantly for males but not females when controlling for baseline demographic factors and CD4 count and percentage, and became nonsignificant in the 2002 to 2004 cohort after controlling for area poverty. Conclusions: Area poverty appears to play a role in racial/ethnic disparities even after controlling for demographic factors and CD4 count and percentage.

Keywords: acquired immune deficiency syndrome; adult; African American; article; Caucasian; CD4 lymphocyte count; chi square distribution; ethnology; female; highly active antiretroviral therapy; human; male; middle aged; poverty; proportional hazards model; retrospective study; statistics; survival; United States, Acquired Immunodeficiency Syndrome; Adult; African Americans; Antiretroviral Therapy, Highly Active; CD4 Lymphocyte Count; Chi-Square Distribution; European Continental Ancestry Group; Female; Florida; Humans; Male; Middle Aged; Poverty; Proportional Hazards Models; Retrospective Studies; Survival Analysis (search for similar items in EconPapers)
Date: 2013
References: Add references at CitEc
Citations: View citations in EconPapers (2)

Downloads: (external link)
http://hdl.handle.net/10.2105/AJPH.2012.300930

Related works:
This item may be available elsewhere in EconPapers: Search for items with the same title.

Export reference: BibTeX RIS (EndNote, ProCite, RefMan) HTML/Text

Persistent link: https://EconPapers.repec.org/RePEc:aph:ajpbhl:10.2105/ajph.2012.300930_2

DOI: 10.2105/AJPH.2012.300930

Access Statistics for this article

American Journal of Public Health is currently edited by Alfredo Morabia

More articles in American Journal of Public Health from American Public Health Association
Bibliographic data for series maintained by Christopher F Baum ().