title: How do outcomes compare between women and men living with HIV in Australia? An observational study.
abstract: Background Gender differences vary across geographical settings and are poorly reported in the literature. The aim of this study was to evaluate demographics and clinical characteristics of participants from the Australian HIV Observational Database (AHOD), and to explore any differences between females and males in the rate of new clinical outcomes, as well as initial immunological and virological response to antiretroviral therapy.
  
  
  
  Time to a new clinical end-point, all-cause mortality and/or AIDS illness was analysed using standard survival methods. Univariate and covariate adjusted Cox proportional hazard models were used to evaluate the time to plasma viral load suppression in all patients that initiated antiretroviral therapy (ART) and time to switching from a first-line ART to a second-line ART regimen.
  
  
  
  There was no significant difference between females and males for the hazard of all-cause mortality [adjusted hazard ratio: 0.98 (0.51, 1.55), P=0.67], new AIDS illness [adjusted hazard ratio: 0.75 (0.38, 1.48), P=0.41] or a composite end-point [adjusted hazard ratio: 0.74 (0.45, 1.21), P=0.23]. Incident rates of all-cause mortality were similar between females and males; 1.14 (0.61, 1.95) vs 1.28 (1.12, 1.45) per 100 person years. Virological response to ART was similar for females and males when measured as time to viral suppression and/or time to virological failure.
  
  
  
  This study supports current Australian HIV clinical care as providing equivalent standards of care for male and female HIV-positive patients. Future studies should compare ART-associated toxicity differences between ART-associated toxicity differences between men and women living with HIV in Australia.
authors.affiliation: Department of Infectious Diseases, Monash University, Clayton, Vic. 3168, Australia.
authors.forename: Michelle L
authors.initials: ML
authors.lastname: Giles
authors.affiliation: RPA Sexual Health, Sydney Local Health District, Sydney, NSW 2050, Australia.
authors.forename: Marin C
authors.initials: MC
authors.lastname: Zapata
authors.affiliation: The Kirby Institute, UNSW Australia, Sydney, NSW 2052, Australia.
authors.forename: Stephen T
authors.initials: ST
authors.lastname: Wright
authors.affiliation: The Kirby Institute, UNSW Australia, Sydney, NSW 2052, Australia.
authors.forename: Kathy
authors.initials: K
authors.lastname: Petoumenos
authors.affiliation: Tamworth Sexual Health Service, Tamworth, NSW 2340, Australia.
authors.forename: Miriam
authors.initials: M
authors.lastname: Grotowski
authors.affiliation: Department of Medicine, Nambour Hospital, Nambour, Qld 4560, Australia.
authors.forename: Jennifer
authors.initials: J
authors.lastname: Broom
authors.affiliation: The Kirby Institute, UNSW Australia, Sydney, NSW 2052, Australia.
authors.forename: Matthew G
authors.initials: MG
authors.lastname: Law
authors.affiliation: RPA Sexual Health, Sydney Local Health District, Sydney, NSW 2050, Australia.
authors.forename: Catherine C
authors.initials: CC
authors.lastname: O'Connor
mesh_terms: D000328:Adult; D019380:Anti-HIV Agents / Q000009:adverse effects / Q000627:therapeutic use*; D001315:Australia; D005260:Female; D015658:HIV Infections / Q000188:drug therapy*; D006801:Humans; D008297:Male; D011787:Quality of Health Care; D012737:Sex Factors; D019562:Viral Load
chemical_list: D019380:Anti-HIV Agents
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