title: Disparities in HIV Clinical Outcomes among a Cohort of HIV-Infected Persons Receiving Care-Mississippi.
abstract: Increasing patients' cluster of differentiation 4 (CD4) count and achieving viral suppression are the ultimate goals of the human immunodeficiency virus (HIV) care and treatment, yet disparities in these HIV clinical outcomes exist among subpopulations of HIV-infected persons. We aimed to assess potential disparities in viral suppression and normal CD4 count among HIV-infected persons receiving care in Mississippi using Mississippi Medical Monitoring Project (MMP) data from 2009 to 2014 (N= 1233) in this study. Outcome variables in this study were suppressed, recent and durable viral load, and normal CD4 count. Patients' characteristics in this study were race, gender, age, annual income, education, insurance, and length of diagnosis. Descriptive statistics, Chi square tests, and logistic regression analyses were conducted using the SAS 9.4 Proc Survey procedure. Our findings indicate that those aged 50 years or older were more likely to have suppressed recent viral load (adjusted Odds Ratio (aOR) = 2.4) and durable viral loads (aOR = 2.9), compared to those aged 18-24 years. In addition, women were more likely to have a normal CD4 count than men (aOR = 1.4). In conclusion, we found that age and gender disparities in HIV clinical outcomes may be used to develop and implement multifaceted interventions to improve health equity among all HIV-infected patients.
authors.affiliation: Mississippi State Department of Health, Office of STD/HIV, 570 E. Woodrow Wilson, Osborne 200, Jackson, MS 39216, USA. ali.dehghanifirouz@msdh.ms.gov.
authors.forename: Ali
authors.initials: A
authors.lastname: Dehghani Firouzabadi
authors.affiliation: Mississippi State Department of Health, Office of STD/HIV, 570 E. Woodrow Wilson, Osborne 200, Jackson, MS 39216, USA. tiffany.mcdonald@msdh.ms.gov.
authors.forename: Tiffany C
authors.initials: TC
authors.lastname: McDonald
authors.affiliation: Mississippi State Department of Health, Office of STD/HIV, 570 E. Woodrow Wilson, Osborne 200, Jackson, MS 39216, USA. tametria.samms@msdh.ms.gov.
authors.forename: Tametria R
authors.initials: TR
authors.lastname: Samms
authors.affiliation: University of Mississippi Medical Center, 2500 N State St, Jackson, MS 39216, USA. rsirous@umc.edu.
authors.forename: Reza
authors.initials: R
authors.lastname: Sirous
authors.affiliation: Mississippi State Department of Health, Office of STD/HIV, 570 E. Woodrow Wilson, Osborne 200, Jackson, MS 39216, USA. kendra.johnson@msdh.ms.gov.
authors.forename: Kendra
authors.initials: K
authors.lastname: Johnson
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D018791:CD4 Lymphocyte Count; D003695:Delivery of Health Care / Q000592:standards / Q000639:trends; D005260:Female; D015658:HIV Infections / Q000188:drug therapy* / Q000276:immunology / Q000821:virology; D054624:Health Status Disparities; D006801:Humans; D008297:Male; D008875:Middle Aged; D008922:Mississippi / Q000453:epidemiology; D044469:Racial Groups / Q000706:statistics & numerical data; D000072230:Sustained Virologic Response; D016896:Treatment Outcome; D019562:Viral Load; D055815:Young Adult
keywords: cluster of differentiation 4; disparities; durable viral load; the human immunodeficiency virus clinical outcomes; viral load suppression