Gender and the use of antiretroviral treatment in resource-constrained settings: findings from a multicenter collaboration.
OBJECTIVE
To compare the gender distribution of HIV-infected adults receiving highly active antiretroviral treatment (HAART) in resource-constrained settings with estimates of the gender distribution of HIV infection; to describe the clinical characteristics of women and men receiving HAART.


METHODS
The Antiretroviral Therapy in Lower-Income Countries, ART-LINC Collaboration is a network of clinics providing HAART in Africa, Latin America, and Asia. We compared UNAIDS data on the gender distribution of HIV infection with the proportions of women and men receiving HAART in the ART-LINC Collaboration.


RESULTS
Twenty-nine centers in 13 countries participated. Among 33,164 individuals, 19,989 (60.3%) were women. Proportions of women receiving HAART in ART-LINC centers were similar to, or higher than, UNAIDS estimates of the proportions of HIV-infected women in all but two centers. There were fewer women receiving HAART than expected from UNAIDS data in one center in Uganda and one center in India. Taking into account heterogeneity across cohorts, women were younger than men, less likely to have advanced HIV infection, and more likely to be anemic at HAART initiation.


CONCLUSIONS
Women in resource-constrained settings are not necessarily disadvantaged in their access to HAART. More attention needs to be paid to ensuring that HIV-infected men are seeking care and starting HAART.
Braitstein
Paula
P
Department of Medicine, Indiana University, Indianapolis, Indiana, USA.
Boulle
Andrew
A
Nash
Denis
D
Brinkhof
Martin W G
MW
Dabis
François
F
Laurent
Christian
C
Schechter
Mauro
M
Tuboi
Suely H
SH
Sprinz
Eduardo
E
Miotti
Paolo
P
Hosseinipour
Mina
M
May
Margaret
M
Egger
Matthias
M
Bangsberg
David R
DR
Low
Nicola
N
D000328:Adult; D000349:Africa / Q000453:epidemiology; D019380:Anti-HIV Agents / Q000627:therapeutic use; D023241:Antiretroviral Therapy, Highly Active / Q000706:statistics & numerical data*; D001208:Asia / Q000453:epidemiology; D003906:Developing Countries; D005260:Female; D015658:HIV Infections / Q000188:drug therapy* / Q000453:epidemiology*; D006297:Health Services Accessibility / Q000706:statistics & numerical data*; D006801:Humans; D007843:Latin America / Q000453:epidemiology; D008297:Male; D011320:Primary Health Care / Q000706:statistics & numerical data; D017678:Sex Distribution; D012945:Social Values; D014944:World Health Organization
D019380:Anti-HIV Agents