955. Race and Gender Differences in HIV-1 RNA Viral load and CD4+ T-cell count in HIV-Infected Persons in Care
Session: Poster Abstract Session: Sexually Transmitted Infections
Friday, October 4, 2013
Room: The Moscone Center: Poster Hall C
Posters
  • Jaiyeoba-74547-42x60-Sep 9.pdf (97.9 kB)
  • Background:

    HIV infection rates  remain especially high among US minorities; HIV prevalence among black women is >20x that of white women. We  characterized HIV-infected patients in our clinic, and compared HIV-1 RNA viral loads (VL) and CD4+ T cell counts of different demographic groups, both at baseline and over years of follow-up from the index date.   We hypothesized that minority women with HIV/AIDS in the southeast have lower CD4+ T cell count and higher HIV-1 RNA VL, and less favorable improvements over time in care, compared with males.

    Methods: IRB-approved retrospective cohort study among persons in care at the Infectious Diseases clinic of the Medical University of South Carolina. We abstracted socio-demographic data and compared HIV-1 RNA VL and CD4+ T-cell count between 2005-2010.

    Results:

    454 females and 779 males were sampled with a mean age of 45 and 47 years, respectively. In the female cohort, 72% were >40 years of age, 80% black, and 79% reported a monthly income of < $1000. In the male cohort, 75% were >40 years of age, 61% black, 73% reported a monthly income of <$1000.

    A multivariate mixed model of CD4+ T-cell count with gender, race and time showed significant interactions (p=0.005), with CD4+ T-cell counts being generally higher and increasing to a slightly greater degree among whites than blacks in care.

    An overall decrease in the percentage of patients who had VL >10,000 copies/ml was observed over time. White males had greater VL suppression than other groups at the index date and black males had greater reductions in VL over time in care, such that over years of follow-up VL suppression was more successful in men than women, regardless of race.  CD4+ T cell counts were lower among blacks than whites at all time points, although black males demonstrated greater improvements in CD4+ T cell counts over time in care compared with black females. 

    Conclusion:

     Results demonstrate disparity in the HIV-1 RNA VL and CD4+ T-cell count between men and women and also between whites and blacks. The CD4+ T-cell counts of black men and women at entry into care was lower than that of their white counterparts and remained at a disadvantage over years in care.   Many potential factors may contribute to these disparities, and further studies are needed, particularly in the black HIV-infected woman, to determine interventions that may improve access to care.

    Oluwatosin Jaiyeoba, MD, Obstetrics and Gynecology/Infectious Diseases, Medical University of South Carolina, Charleston, SC, M. Sean Boger, MD, PharmD, Medicine, Division of Infectious Diseases, Medical University of South Carolina, Charleston, SC, Paul Nietert, Ph.D., Public Health Sciences, Medical University of South Carolina, Charleston, SC and J. Michael Kilby, MD FACP, Medicine, Medical University of South Carolina, Charleston, SC

    Disclosures:

    O. Jaiyeoba, None

    M. S. Boger, None

    P. Nietert, None

    J. M. Kilby, None

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