Sociostructural correlates of AIDS progression for african american women living with diagnoses of HIV infection in the District of Columbia

Yzette Lanier, Jenevieve Opoku, Yujiang Jia, Leigh A. Willis, Kim Elmore, Tiffany West, Anna Satcher Johnson, Madeline Y. Sutton

Research output: Contribution to journalArticle

Abstract

Background: Among women living with HIV infection in the District of Columbia (DC), African American women are disproportionately affected, comprising > 90% of reported cases. Sociostructural exploration of local HIV epidemics among African American women has been understudied. We explored sociostructural correlates of health for HIVinfected African American women in DC to inform local HIV prevention and intervention efforts. Methods: HIV surveillance data from the District of Columbia Department of Health for African American women living with HIV were reviewed. We analyzed data for sociostructural correlates for progressing to acquired immune deficiency syndrome (AIDS) (CD4 counts < 200 cells/ml) among African American women. Data were analyzed using SAS 9.2 and mapped by census tracts using ArcGIS. Results: Of 4,619 women living with HIV, 4,204 (91%) were African American; 3,050 (72.5%) had census tract information available and were included. Median age at diagnosis was 36.6 years. Among these 3,050 African American women, 1,814 (59.4%) had ever progressed to AIDS, 1,109 (36.4%) had CD4 counts < 200 cells/μl (AIDS) at most recent clinical visit, and 208 of 1,109 (18.8%) had progressed to AIDS within 12 months of their HIV diagnosis (late testers). Women who progressed to AIDS had a higher probability of being diagnosed at private facilities compared with public facilities (PR=1.1, 95% CI=1.1-1.3) and of being exposed through injection drug use (IDU) compared to being exposed through heterosexual contact (PR=1.3, 95% CI=1.2-1.5). In multivariate and geomapping analyses, poverty, education levels and census tracts were not associated with an AIDS diagnosis. Conclusion: Progression to AIDS is prevalent among HIV-infected African American women in DC. Increased, early routine HIV screening and intensified treatment efforts with African American women living with HIV infection in DC, regardless of socioeconomic status, are warranted, to improve outcomes and decrease disparities.

Original languageEnglish (US)
Article number1000254
JournalJournal of AIDS and Clinical Research
Volume4
Issue number11
DOIs
StatePublished - 2013

Fingerprint

African Americans
HIV Infections
Acquired Immunodeficiency Syndrome
HIV
Censuses
CD4 Lymphocyte Count
Public Facilities
Delayed Diagnosis
Heterosexuality
Health
Poverty
Social Class
Multivariate Analysis
Education
Injections

Keywords

  • African American
  • AIDS
  • District of Columbia
  • HIV
  • Sociostructural determinants
  • Women

ASJC Scopus subject areas

  • Infectious Diseases
  • Dermatology
  • Immunology
  • Virology

Cite this

Sociostructural correlates of AIDS progression for african american women living with diagnoses of HIV infection in the District of Columbia. / Lanier, Yzette; Opoku, Jenevieve; Jia, Yujiang; Willis, Leigh A.; Elmore, Kim; West, Tiffany; Johnson, Anna Satcher; Sutton, Madeline Y.

In: Journal of AIDS and Clinical Research, Vol. 4, No. 11, 1000254, 2013.

Research output: Contribution to journalArticle

Lanier, Yzette ; Opoku, Jenevieve ; Jia, Yujiang ; Willis, Leigh A. ; Elmore, Kim ; West, Tiffany ; Johnson, Anna Satcher ; Sutton, Madeline Y. / Sociostructural correlates of AIDS progression for african american women living with diagnoses of HIV infection in the District of Columbia. In: Journal of AIDS and Clinical Research. 2013 ; Vol. 4, No. 11.
@article{d882e7c1c5c147b8b880efb1b05317ff,
title = "Sociostructural correlates of AIDS progression for african american women living with diagnoses of HIV infection in the District of Columbia",
abstract = "Background: Among women living with HIV infection in the District of Columbia (DC), African American women are disproportionately affected, comprising > 90{\%} of reported cases. Sociostructural exploration of local HIV epidemics among African American women has been understudied. We explored sociostructural correlates of health for HIVinfected African American women in DC to inform local HIV prevention and intervention efforts. Methods: HIV surveillance data from the District of Columbia Department of Health for African American women living with HIV were reviewed. We analyzed data for sociostructural correlates for progressing to acquired immune deficiency syndrome (AIDS) (CD4 counts < 200 cells/ml) among African American women. Data were analyzed using SAS 9.2 and mapped by census tracts using ArcGIS. Results: Of 4,619 women living with HIV, 4,204 (91{\%}) were African American; 3,050 (72.5{\%}) had census tract information available and were included. Median age at diagnosis was 36.6 years. Among these 3,050 African American women, 1,814 (59.4{\%}) had ever progressed to AIDS, 1,109 (36.4{\%}) had CD4 counts < 200 cells/μl (AIDS) at most recent clinical visit, and 208 of 1,109 (18.8{\%}) had progressed to AIDS within 12 months of their HIV diagnosis (late testers). Women who progressed to AIDS had a higher probability of being diagnosed at private facilities compared with public facilities (PR=1.1, 95{\%} CI=1.1-1.3) and of being exposed through injection drug use (IDU) compared to being exposed through heterosexual contact (PR=1.3, 95{\%} CI=1.2-1.5). In multivariate and geomapping analyses, poverty, education levels and census tracts were not associated with an AIDS diagnosis. Conclusion: Progression to AIDS is prevalent among HIV-infected African American women in DC. Increased, early routine HIV screening and intensified treatment efforts with African American women living with HIV infection in DC, regardless of socioeconomic status, are warranted, to improve outcomes and decrease disparities.",
keywords = "African American, AIDS, District of Columbia, HIV, Sociostructural determinants, Women",
author = "Yzette Lanier and Jenevieve Opoku and Yujiang Jia and Willis, {Leigh A.} and Kim Elmore and Tiffany West and Johnson, {Anna Satcher} and Sutton, {Madeline Y.}",
year = "2013",
doi = "10.4172/2155-6113.1000254",
language = "English (US)",
volume = "4",
journal = "Journal of AIDS and Clinical Research",
issn = "2155-6113",
publisher = "OMICS Publishing Group",
number = "11",

}

TY - JOUR

T1 - Sociostructural correlates of AIDS progression for african american women living with diagnoses of HIV infection in the District of Columbia

AU - Lanier, Yzette

AU - Opoku, Jenevieve

AU - Jia, Yujiang

AU - Willis, Leigh A.

AU - Elmore, Kim

AU - West, Tiffany

AU - Johnson, Anna Satcher

AU - Sutton, Madeline Y.

PY - 2013

Y1 - 2013

N2 - Background: Among women living with HIV infection in the District of Columbia (DC), African American women are disproportionately affected, comprising > 90% of reported cases. Sociostructural exploration of local HIV epidemics among African American women has been understudied. We explored sociostructural correlates of health for HIVinfected African American women in DC to inform local HIV prevention and intervention efforts. Methods: HIV surveillance data from the District of Columbia Department of Health for African American women living with HIV were reviewed. We analyzed data for sociostructural correlates for progressing to acquired immune deficiency syndrome (AIDS) (CD4 counts < 200 cells/ml) among African American women. Data were analyzed using SAS 9.2 and mapped by census tracts using ArcGIS. Results: Of 4,619 women living with HIV, 4,204 (91%) were African American; 3,050 (72.5%) had census tract information available and were included. Median age at diagnosis was 36.6 years. Among these 3,050 African American women, 1,814 (59.4%) had ever progressed to AIDS, 1,109 (36.4%) had CD4 counts < 200 cells/μl (AIDS) at most recent clinical visit, and 208 of 1,109 (18.8%) had progressed to AIDS within 12 months of their HIV diagnosis (late testers). Women who progressed to AIDS had a higher probability of being diagnosed at private facilities compared with public facilities (PR=1.1, 95% CI=1.1-1.3) and of being exposed through injection drug use (IDU) compared to being exposed through heterosexual contact (PR=1.3, 95% CI=1.2-1.5). In multivariate and geomapping analyses, poverty, education levels and census tracts were not associated with an AIDS diagnosis. Conclusion: Progression to AIDS is prevalent among HIV-infected African American women in DC. Increased, early routine HIV screening and intensified treatment efforts with African American women living with HIV infection in DC, regardless of socioeconomic status, are warranted, to improve outcomes and decrease disparities.

AB - Background: Among women living with HIV infection in the District of Columbia (DC), African American women are disproportionately affected, comprising > 90% of reported cases. Sociostructural exploration of local HIV epidemics among African American women has been understudied. We explored sociostructural correlates of health for HIVinfected African American women in DC to inform local HIV prevention and intervention efforts. Methods: HIV surveillance data from the District of Columbia Department of Health for African American women living with HIV were reviewed. We analyzed data for sociostructural correlates for progressing to acquired immune deficiency syndrome (AIDS) (CD4 counts < 200 cells/ml) among African American women. Data were analyzed using SAS 9.2 and mapped by census tracts using ArcGIS. Results: Of 4,619 women living with HIV, 4,204 (91%) were African American; 3,050 (72.5%) had census tract information available and were included. Median age at diagnosis was 36.6 years. Among these 3,050 African American women, 1,814 (59.4%) had ever progressed to AIDS, 1,109 (36.4%) had CD4 counts < 200 cells/μl (AIDS) at most recent clinical visit, and 208 of 1,109 (18.8%) had progressed to AIDS within 12 months of their HIV diagnosis (late testers). Women who progressed to AIDS had a higher probability of being diagnosed at private facilities compared with public facilities (PR=1.1, 95% CI=1.1-1.3) and of being exposed through injection drug use (IDU) compared to being exposed through heterosexual contact (PR=1.3, 95% CI=1.2-1.5). In multivariate and geomapping analyses, poverty, education levels and census tracts were not associated with an AIDS diagnosis. Conclusion: Progression to AIDS is prevalent among HIV-infected African American women in DC. Increased, early routine HIV screening and intensified treatment efforts with African American women living with HIV infection in DC, regardless of socioeconomic status, are warranted, to improve outcomes and decrease disparities.

KW - African American

KW - AIDS

KW - District of Columbia

KW - HIV

KW - Sociostructural determinants

KW - Women

UR - http://www.scopus.com/inward/record.url?scp=84890834472&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84890834472&partnerID=8YFLogxK

U2 - 10.4172/2155-6113.1000254

DO - 10.4172/2155-6113.1000254

M3 - Article

VL - 4

JO - Journal of AIDS and Clinical Research

JF - Journal of AIDS and Clinical Research

SN - 2155-6113

IS - 11

M1 - 1000254

ER -