Visnegarwala F, Graviss EA, Sajja P, Clinton A, White J, Lahart CJ; International Conference on AIDS.
Int Conf AIDS. 2000 Jul 9-14; 13: abstract no. ThPeB5016.
F. Visnegarwala, Baylor College of Medicine, Room #424, Thomas Street Clinic, 2015 Thomas Street, Houston, Texas-77009, United States, Tel.: +101-713-793-4069, Fax: +101-713-793-4047, E-mail: fehmidav@bcm.tmc.edu
Background/Aim: The benefits of HAART does not extend to all segments of the population. Virological Success (VLS) with HAART is dependant on strict adherence, which is influenced by psychosocial and ethnic factors. We evaluated predictors of VLS (i.e.,> 400 RNA at 6 mths) and rates of VLS among different ethnic groups, at an indigent HIV Clinic, where the population reflects the current US epidemic trends: 54% Black(B), 24% White(W), 21%Hispanic(His), 71% male (M), 41% Gay (G), 41% heterosexual(H) and 12% IDU. Methods: A retrospective review of new patients presenting between 4-12/98. The following variables among patients with with and without VLS were compared: demographics, Baseline (BL) HIV status, HAART use, substance use, adherence, incarceration, other illnesses, HIV-care expertise among providers. Results: Among the 369 new pts, 39% had AIDS, 64% were antiretroviral naive, 73% received HAART. Of the 190 who had a 6-mth follow up, 115(61%) had VLS. Following variables were predictive of VLS on multivariate regression analysis: BL VL > 100K (OR:1.63; CI: 0.98-2.72,p = 0.06); Care by experienced provider (OR:2.84; CI:1.46-5.49, p > 0.05); Adherence(missed >2 refills) (OR:6.11 CI:3.67-10.17, p > 0.01). The VLS and BL HIVstatus among different ethnic risk groups were compared to traditional GWM > 35 yrs. Among GWM > 35 (n = 30), Gminority M (n = 51), HBM (n = 53), HhisM(n = 22),HBF(n = 26), Hhis F(n = 12), the rates of VLS(%) were: 74, 68, 65, 68, 70, 66; BL CD4 mean/median were: 248/142, 235/154, 206/170,136/97(*), 230/127,313/230; BL VL (K) mean/median were: 219/95, 220/85, 97/69, 152/36, 253/157, 178/601 respectively (all except * were NS). Conclusions: Among the indigent population , representative of today's epidemic, the rates of VLS with HAART are low. This is mainly due to lack of adherence and not late utilization of care by ethnic minorities. Improving adherence with better support systems as in older gay men may improve the outcomes in this population and impact the epidemic.
Publication Types:
Keywords:
- Acquired Immunodeficiency Syndrome
- Ambulatory Care Facilities
- Antiretroviral Therapy, Highly Active
- HIV Infections
- HIV Seropositivity
- Humans
- Male
- Minority Groups
- Poverty
- Substance-Related Disorders
- utilization
Other ID:
UI: 102241492
From Meeting Abstracts