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Black-white mortality from HIV in the United States before and after introduction of highly active antiretroviral therapy in 1996

Author

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  • Levine, R.S.
  • Briggs, N.C.
  • Kilbourne, B.S.
  • King, W.D.
  • Fry-Johnson, Y.
  • Baltrus, P.T.
  • Husaini, B.A.
  • Rust, G.S.

Abstract

Objectives. We sought to describe Black-White differences in HIV disease mortality before and after the introduction of highly active antiretroviral treatment (HAART). Methods. Black-White mortality from HIV is described for the nation as a whole. We performed regression analyses to predict county-level mortality for Black men aged 25-84 years and the corresponding Black:White male mortality ratios (disparities) in 140 counties with reliable Black mortality for 1999-2002. Results. National Black-White disparities widened significantly after the introduction of HAART, especially among women and the elderly. In county regression analyses, contextual socioeconomic status (SES) was not a significant predictor of Black:White mortality rate ratio after we controlled for percentage of the population who were Black and percentage of the population who were Hispanic, and neither contextual SES nor race/ethnicity were significant predictors after we controlled for pre-HAART mortality. Contextual SES, race, and pre-HAART mortality were all significant and independent predictors of mortality among Black men. Conclusions. Although nearly all segments of the Black population experienced widened post-HAART disparities, disparities were not inevitable and tended to reflect pre-HAART levels. Public health policymakers should consider the hypothesis of unequal diffusion of the HAART innovation, with place effects rendering some communities more vulnerable than others to this potential problem.

Suggested Citation

  • Levine, R.S. & Briggs, N.C. & Kilbourne, B.S. & King, W.D. & Fry-Johnson, Y. & Baltrus, P.T. & Husaini, B.A. & Rust, G.S., 2007. "Black-white mortality from HIV in the United States before and after introduction of highly active antiretroviral therapy in 1996," American Journal of Public Health, American Public Health Association, vol. 97(10), pages 1884-1892.
  • Handle: RePEc:aph:ajpbhl:10.2105/ajph.2005.081489_3
    DOI: 10.2105/AJPH.2005.081489
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    Cited by:

    1. Anne D. Kershenbaum & Michael A. Langston & Robert S. Levine & Arnold M. Saxton & Tonny J. Oyana & Barbara J. Kilbourne & Gary L. Rogers & Lisaann S. Gittner & Suzanne H. Baktash & Patricia Matthews-J, 2014. "Exploration of Preterm Birth Rates Using the Public Health Exposome Database and Computational Analysis Methods," IJERPH, MDPI, vol. 11(12), pages 1-21, November.
    2. Aburto, José Manuel & Kristensen, Frederikke Frehr & Sharp, Paul, 2021. "Black-white disparities during an epidemic: Life expectancy and lifespan disparity in the US, 1980–2000," Economics & Human Biology, Elsevier, vol. 40(C).
    3. Paul D. Juarez & Patricia Matthews-Juarez & Darryl B. Hood & Wansoo Im & Robert S. Levine & Barbara J. Kilbourne & Michael A. Langston & Mohammad Z. Al-Hamdan & William L. Crosson & Maurice G. Estes &, 2014. "The Public Health Exposome: A Population-Based, Exposure Science Approach to Health Disparities Research," IJERPH, MDPI, vol. 11(12), pages 1-30, December.
    4. Rice, Whitney S. & Logie, Carmen H. & Napoles, Tessa M. & Walcott, Melonie & Batchelder, Abigail W. & Kempf, Mirjam-Colette & Wingood, Gina M. & Konkle-Parker, Deborah J. & Turan, Bulent & Wilson, Tra, 2018. "Perceptions of intersectional stigma among diverse women living with HIV in the United States," Social Science & Medicine, Elsevier, vol. 208(C), pages 9-17.
    5. Sam Harper & Nicholas B King & Meredith E Young, 2013. "Impact of Selective Evidence Presentation on Judgments of Health Inequality Trends: An Experimental Study," PLOS ONE, Public Library of Science, vol. 8(5), pages 1-7, May.
    6. Irma Elo & Hiram Beltrán-Sánchez & James Macinko, 2014. "The Contribution of Health Care and Other Interventions to Black–White Disparities in Life Expectancy, 1980–2007," Population Research and Policy Review, Springer;Southern Demographic Association (SDA), vol. 33(1), pages 97-126, February.

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