title: Racial variations in care and outcomes for inpatient HIV-related pneumocystis pneumonia.
abstract: Racial disparities in HIV-care include the disproportionate impact of HIV/AIDS on African Americans. We conducted a retrospective review of 1,855 cases at 78 hospitals in nine cities to evaluate racial variations in inpatient care for AIDS-related Pneumocystis pneumonia (PCP) shortly after the introduction of highly active anti-retroviral therapies. While inpatient HIV-related PCP mortality was comparable between Whites and Hispanics (p=0.94), African Americans were less likely than Whites to die in-hospital (AOR 0.69, 95% CI 0.48, 0.99) and more likely to receive timely anti-PCP medications (AOR 1.67, 95% CI 1.21, 2.30) and timely corticosteroids (AOR 1.46, 95% CI 1.17, 1.82). Findings were compared with those from our study involving 1,547 patients at 82 hospitals in five cities over the first decade of the AIDS epidemic. In contrast to the first study, in the second decade African Americans were more likely to receive timely and appropriate therapy for HIV-related PCP, and resultantly were more likely to survive the hospitalization.
authors.affiliation: Health Services Research and Policy, Hines VA Hospital in Hines, Illinois, USA.
authors.forename: Jorge P
authors.initials: JP
authors.lastname: Parada
authors.forename: Paul R
authors.initials: PR
authors.lastname: Yarnold
authors.forename: Constance R
authors.initials: CR
authors.lastname: Uphold
authors.forename: Joan S
authors.initials: JS
authors.lastname: Chmiel
authors.forename: Jack A
authors.initials: JA
authors.lastname: DeHovitz
authors.forename: Matthew B
authors.initials: MB
authors.lastname: Goetz
authors.forename: Robert A
authors.initials: RA
authors.lastname: Weinstein
authors.forename: June M
authors.initials: JM
authors.lastname: McKoy
authors.forename: Kevin L
authors.initials: KL
authors.lastname: Chandler
authors.forename: Charles L
authors.initials: CL
authors.lastname: Bennett
mesh_terms: D017088:AIDS-Related Opportunistic Infections / Q000188:drug therapy / Q000208:ethnology* / Q000401:mortality; D000293:Adolescent; D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D000328:Adult; D001741:Black or African American / Q000706:statistics & numerical data*; D023241:Antiretroviral Therapy, Highly Active; D005260:Female; D054625:Healthcare Disparities / Q000706:statistics & numerical data*; D006630:Hispanic or Latino / Q000706:statistics & numerical data*; D017052:Hospital Mortality / Q000208:ethnology*; D006760:Hospitalization / Q000706:statistics & numerical data; D006786:Hospitals, Urban; D006801:Humans; D008297:Male; D008875:Middle Aged; D011020:Pneumonia, Pneumocystis / Q000188:drug therapy / Q000208:ethnology* / Q000401:mortality; D012189:Retrospective Studies; D016896:Treatment Outcome; D014481:United States; D044465:White People / Q000706:statistics & numerical data*; D055815:Young Adult
chemical_list: D000305:Adrenal Cortex Hormones