Although treatments for HIV have dramatically improved, disparities persist along racial lines. These are amplified when considering potential life lost.
Since the introduction of antiretroviral therapies, the mortality rates of people with HIV have decreased substantially. However, premature deaths are currently not included in these calculations. Additionally, sex and race disparities persist. Various minority groups are affected by HIV at disproportionally high rates in the United States, with females being more likely to receive delays in diagnoses, along with patients who are Black, Hispanic/Latino, and those who are older. This study, published in the journal Open Forum Infectious Diseases, analyzes these disparities over a period of 21 years, while also providing an analysis of potential life lost among people with HIV.
Analyzing Potential Life Lost in Addition to Mortality
Analyzing mortality alone can create a skewed picture of the effects of a disease, because patients who die earlier than they would if healthy still lose a substantial number of life years, even if they do not die as a direct result of the disease. This article analyzes potential life lost by comparing an individual’s time of death to US sex-specific period life tables by age and year of death.
The results showed that Black women had the highest years of potential life lost, followed by Black men, White women, and lastly, White men. This indicates that even though novel therapies are available and highly effective, health disparaties may be causing lower utilization rates.
Mortality Rates Among People With HIV
Overall mortality rates have decreased dramatically, falling 78% when comparing the most recent calendar era (2014–2018) to the earliest (1998–2003). However, adjusted analyses show that women had a 31% increased risk of mortality. The authors note that the prevalence of HIV among women has increased dramatically in the US, with women now making up 21% of people with HIV.
Women face unique healthcare challenges with HIV, often receiving diagnosis and care later than other groups. These disparities can be compounded by racial and economic factors, with Black women losing a larger number of years overall compared to White women. Analyzing the causes of these disparities is essential to providing equitable care to those with HIV.
Source:
Pellegrino, R., Rebeiro, P. F., Turner, M. C., Davidson, A., Best, N., Shaffernocker, C., Kheshti, A., Kelly, S., Raffanti, S., Sterling, T. R., & Castilho, J. L. (2022). Sex and Race Disparities in Mortality and Years of Potential Life Lost Among People With HIV: A 21-Year Observational Cohort Study. Open Forum Infectious Diseases, 10(1). https://doi.org/10.1093/ofid/ofac678
