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

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.