Minorities, the poor, and survivors of abuse: HIV-infected patients in the US deep South.
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.
Pence
Brian Wells
BW
Health Inequalities Program, Duke University, Center for Health Policy, Duke University, Durham, NC 27708, USA. bpence@aya.yale.edu
Reif
Susan
S
Whetten
Kathryn
K
Leserman
Jane
J
Stangl
Dalene
D
Swartz
Marvin
M
Thielman
Nathan
N
Mugavero
Michael J
MJ
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