Ethnic differences in hiv disease progression: a comparison of Asian/Pacific Islanders and Whites living in Hawaii.
OBJECTIVE
To characterize the association of demographic factors with the relative hazards (RH) of developing AIDS or death among HIV-infected individuals of Asian/Pacific Islander (API) ethnicity and Whites.


METHODS
Cohort study


METHODS
Hawaii State Health Department database of HIV-infected individuals


METHODS
Hawaii Sero-Positivity and Medical Management (HSPAMM) program participants from January 1989 to November 2002


METHODS
None


METHODS
Differences in the time to develop AIDS or death among HIV-infected individuals who reported being on highly active antiretroviral treatment (HAART) were examined by ethnicity, income, and CD4+ cell counts at HAART initiation by using Kaplan-Meier survival analysis and Cox proportional hazard analyses.


RESULTS
The study was based on 516 HIV-infected individuals, who were primarily White (61.0%) and API (21.7%). Whites had a significantly higher CD4+ cell count (P<.01) and income (P<.01) than APIs at enrollment into HSPAMM. Lower income levels and CD4+ cell counts at HAART initiation were strongly associated with an increased RH of developing AIDS or dying. Despite having significantly lower incomes and CD4+ cell counts at enrollment, individuals of API ethnicity do not have an increased RH of developing the outcomes compared to Whites.


CONCLUSIONS
Lower income and CD4+ cell counts at HAART initiation significantly increased the RH of developing AIDS or dying among HIV-infected individuals. Asian/Pacific Islander (API) ethnicity was not a predictor of developing AIDS or dying.
Shimizu
Sheri M
SM
Department of Medicine and Pediatrics, University of Hawaii John A. Burns School of Medicine, Honolulu, Hawaii 96816, USA.
Chow
Dominic C
DC
Katz
Alan R
AR
Richmond-Crum
Suzanne
S
Miller
F DeWolfe
FD
D000328:Adult; D018450:Disease Progression; D005006:Ethnicity; D005260:Female; D015658:HIV Infections / Q000503:physiopathology*; D006254:Hawaii; D006801:Humans; D008297:Male; D008875:Middle Aged; D011159:Population Surveillance; D011795:Surveys and Questionnaires