177891 Gender Differences in the Progression to AIDS and Mortality in the Houston Surveillance Project

Monday, October 27, 2008: 2:45 PM

Raouf Arafat, MD, MPH , Houston Department of Health and Human Services, Houston, TX
Adebowale Awosika-olumo, MD MS MPH , Houston Department of Health and Human Services, Bureau of Epidemiology, Houston, TX
Marcia Wolverton, MPH , Bureau of Epidemiology, Houston Department of Health and Human Services, Houston, TX
James Gomez , Houston Department of Health and Human Services, Bureau of Epidemiology, Houston, TX
Lydwina Anderson , Houston Department of Health and Human Services, Bureau of Epidemiology, Houston, TX
OBJECTIVE: To examine the differences between genders in the progression to AIDS and early mortality in person living with HIV/AIDS by racial/ethnic backgrounds.

METHOD: We analyzed, from a multi-center hospital and clinic based cohort, 5331 HIV-infected patients (ASD Project 1990-2001). The statistical analysis was performed using Kaplan-Meier, Log Rank test, and Cox proportional regression analysis for examining the effect of gender on the time to AIDS progression and consequent survival from AIDS.

RESULTS: Univariate analysis showed overall gender difference, that males progressed earlier to AIDS than females (p < .001). When gender differences were examined by individual race/ethnic groups, African-American males were more likely to progress early to AIDS (p = .012) including early mortality (p < .001) when compared to African-American females. Multivariate regression analysis, adjusting for gender, age, and social risk factors revealed the lower likelihood of prescribed anti-retrovirals to African-American males to be a predictor to early progression to AIDS (HR = 1.3; 95% CI 1.2 1.5). No significant gender differences in HIV progression were seen in White and Latino race/ethnic groups.

CONCLUSION: The findings of this study indicate that African-American males are more likely than African-American females to progress earlier to AIDS and mortality. These results highlight the importance of, and the critical role antiretroviral therapy, and its relation to AIDS progression and mortality.

Learning Objectives:
To examine the differences between genders in the progression to AIDS and early mortality in person living with HIV/AIDS by racial/ethnic backgrounds.

Keywords: Evidence Based Practice, Health Disparities

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I played a lead role in the conceptualization and development of the project and the abstract.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.