Disparities in antiretroviral prescribing for blacks and whites in the United States.
OBJECTIVE
The health benefits for blacks on highly active antiretroviral therapy (HAART) lags behind that of whites. We therefore investigated whether this discrepancy in health outcomes is attributable to disparities in the receipt of appropriate HAART between black and white human immunodeficiency virus (HIV) patients.


METHODS
The 2000-2005 National Ambulatory Medical Care Surveys were used to identify patients receiving antiretrovirals. Regimens were evaluated for appropriateness according to national antiretroviral guideline recommendations. A multivariable logistic regression model was used to assess black race as a predictor for appropriate HAART.


RESULTS
An estimated 4.1 million HIV-related visits with antiretroviral therapy were identified. Eighty-six percent of visits were associated with appropriate therapy; inappropriate therapy was often due to antiretroviral monotherapy. Interestingly, blacks were more likely to receive appropriate therapy in comparison to white patients (94% vs 83%, P < .001). Multivariable analysis revealed black race as an independent predictor for an appropriate regimen (chi2 likelihood ratio, 12.3, P < .001) when controlling for age, gender, insurance status, and geographic region.


CONCLUSIONS
Health outcome disparities between black and white HIV patients do not appear to be attributable to differences in receipt of appropriate HAART. Further investigations are warranted to identify factors responsible for these outcome disparities.
Oramasionwu
Christine U
CU
The University of Texas at Austin College of Pharmacy, Austin, Texas, USA.
Skinner
Jeff
J
Ryan
Laurajo
L
Frei
Christopher R
CR
D000328:Adult; D023241:Antiretroviral Therapy, Highly Active; D011307:Drug Prescriptions; D005260:Female; D015658:HIV Infections / Q000188:drug therapy* / Q000208:ethnology*; D054625:Healthcare Disparities; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D014481:United States