title: Minorities, the poor, and survivors of abuse: HIV-infected patients in the US deep South.
abstract: BACKGROUND
  The HIV/AIDS epidemic in the U.S. South is undergoing a marked shift toward a greater proportion of new HIV/AIDS cases in women, African-Americans, and through heterosexual transmission.
  
  
  METHODS
  Using consecutive sampling, 611 participants were interviewed from eight Infectious Diseases clinics in five southeastern states in 2001 to 2002.
  
  
  RESULTS
  Sixty four percent of participants were African-American, 31% were female, and 43% acquired HIV through heterosexual sex; 25% had private health insurance. Eighty-one percent were on antiretroviral therapy, and 46% had HIV RNA viral loads (VL) <400. Women and racial/ethnic minorities were less likely to be on antiretrovirals and to have VL <400. Probable psychiatric disorders (54%) and history of childhood sexual (30%) and physical abuse (21%) were common.
  
  
  CONCLUSIONS
  Prevention and care systems need to address the HIV epidemic's shift into poor, minority, and female populations. High levels of trauma and probable psychiatric disorders indicate a need to assess for and address these conditions in HIV clinical care.
authors.affiliation: Health Inequalities Program, Duke University, Center for Health Policy, Duke University, Durham, NC 27708, USA. bpence@aya.yale.edu
authors.forename: Brian Wells
authors.initials: BW
authors.lastname: Pence
authors.forename: Susan
authors.initials: S
authors.lastname: Reif
authors.forename: Kathryn
authors.initials: K
authors.lastname: Whetten
authors.forename: Jane
authors.initials: J
authors.lastname: Leserman
authors.forename: Dalene
authors.initials: D
authors.lastname: Stangl
authors.forename: Marvin
authors.initials: M
authors.lastname: Swartz
authors.forename: Nathan
authors.initials: N
authors.lastname: Thielman
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Mugavero
mesh_terms: D000328:Adult; D001741:Black or African American / Q000706:statistics & numerical data; D000368:Aged; D000704:Analysis of Variance; D023241:Antiretroviral Therapy, Highly Active; D016009:Chi-Square Distribution; D015897:Comorbidity; D017579:Domestic Violence / Q000706:statistics & numerical data; D005260:Female; D015658:HIV Infections / Q000188:drug therapy / Q000453:epidemiology* / Q000208:ethnology / Q000635:transmission; D006801:Humans; D008297:Male; D008875:Middle Aged; D011204:Poverty Areas; D012307:Risk Factors; D012424:Rural Population; D012737:Sex Factors; D015144:Southeastern United States / Q000453:epidemiology; D017741:Survivors; D019562:Viral Load