Abstract
HIV/AIDS is a disease that has a disproportionate negative impact on the African-American and Latino communities when compared with the general population. African Americans account for more than 50% of new AIDS cases, though they comprise only 12% of the general population. More than one-third of AIDS-related deaths in the United States have been among African Americans. Many factors contribute to the HIV/AIDS healthcare disparities seen in the African-American and Latino communities. These factors include medical issues (such as resistance to antiretroviral therapy, toxicities of medications and hepatitis-C coinfection) and social factors (such as a lack of faith in the healthcare system, cultural circumstances and poor access to healthcare services). Healthcare providers can take steps to improve HIV care for African Americans and Latinos. Distrust of the medical establishment can be addressed by increasing the number of culturally sensitive healthcare providers. Communication is the first step toward establishing the trust of patients and minimizing the devastating effects of perceived institutional bias that may lead many HIV patients to be diagnosed late in the course of the disease. Medical and cultural issues faced by African Americans and Latinos should also be addressed in treatment guidelines. When healthcare providers take steps to overcome the medical and cultural issues facing African Americans and Latinos, HIV patients will have access to more effective disease management.
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Selected References
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- Benhamou Y., Bochet M., Di Martino V., Charlotte F., Azria F., Coutellier A., Vidaud M., Bricaire F., Opolon P., Katlama C. Liver fibrosis progression in human immunodeficiency virus and hepatitis C virus coinfected patients. The Multivirc Group. Hepatology. 1999 Oct;30(4):1054–1058. doi: 10.1002/hep.510300409. [DOI] [PubMed] [Google Scholar]
- Benhamou Y., Di Martino V., Bochet M., Colombet G., Thibault V., Liou A., Katlama C., Poynard T., MultivirC Group Factors affecting liver fibrosis in human immunodeficiency virus-and hepatitis C virus-coinfected patients: impact of protease inhibitor therapy. Hepatology. 2001 Aug;34(2):283–287. doi: 10.1053/jhep.2001.26517. [DOI] [PubMed] [Google Scholar]
- Blair Janet M., Fleming Patricia L., Karon John M. Trends in AIDS incidence and survival among racial/ethnic minority men who have sex with men, United States, 1990-1999. J Acquir Immune Defic Syndr. 2002 Nov 1;31(3):339–347. doi: 10.1097/00126334-200211010-00011. [DOI] [PubMed] [Google Scholar]
- Bogart L. M., Catz S. L., Kelly J. A., Benotsch E. G. Factors influencing physicians' judgments of adherence and treatment decisions for patients with HIV disease. Med Decis Making. 2001 Jan-Feb;21(1):28–36. doi: 10.1177/0272989X0102100104. [DOI] [PubMed] [Google Scholar]
- Brawley O. W. The study of untreated syphilis in the negro male. Int J Radiat Oncol Biol Phys. 1998 Jan 1;40(1):5–8. doi: 10.1016/s0360-3016(97)00835-3. [DOI] [PubMed] [Google Scholar]
- Chesney Margaret. Adherence to HAART regimens. AIDS Patient Care STDS. 2003 Apr;17(4):169–177. doi: 10.1089/108729103321619773. [DOI] [PubMed] [Google Scholar]
- Fleckenstein Jaquelyn. Chronic hepatitis C in African Americans and other minority groups. Curr Gastroenterol Rep. 2004 Feb;6(1):66–70. doi: 10.1007/s11894-004-0028-z. [DOI] [PubMed] [Google Scholar]
- Gifford Allen L., Cunningham William E., Heslin Kevin C., Andersen Ron M., Nakazono Terry, Lieu Dale K., Shapiro Martin F., Bozzette Samuel A., HIV Cost and Services Utilization Study Consortium Participation in research and access to experimental treatments by HIV-infected patients. N Engl J Med. 2002 May 2;346(18):1373–1382. doi: 10.1056/NEJMsa011565. [DOI] [PubMed] [Google Scholar]
- Greenberg R. G., Berger T. G. Nail and mucocutaneous hyperpigmentation with azidothymidine therapy. J Am Acad Dermatol. 1990 Feb;22(2 Pt 2):327–330. doi: 10.1016/0190-9622(90)70039-k. [DOI] [PubMed] [Google Scholar]
- Guinan M. E. Black communities' belief in "AIDS as genocide". A barrier to overcome for HIV prevention. Ann Epidemiol. 1993 Mar;3(2):193–195. doi: 10.1016/1047-2797(93)90136-r. [DOI] [PubMed] [Google Scholar]
- Harawa Nina T., Greenland Sander, Bingham Trista A., Johnson Denise F., Cochran Susan D., Cunningham William E., Celentano David D., Koblin Beryl A., LaLota Marlene, MacKellar Duncan A. Associations of race/ethnicity with HIV prevalence and HIV-related behaviors among young men who have sex with men in 7 urban centers in the United States. J Acquir Immune Defic Syndr. 2004 Apr 15;35(5):526–536. doi: 10.1097/00126334-200404150-00011. [DOI] [PubMed] [Google Scholar]
- Hirsch Martin S., Brun-Vézinet Françoise, Clotet Bonaventura, Conway Brian, Kuritzkes Daniel R., D'Aquila Richard T., Demeter Lisa M., Hammer Scott M., Johnson Victoria A., Loveday Clive. Antiretroviral drug resistance testing in adults infected with human immunodeficiency virus type 1: 2003 recommendations of an International AIDS Society-USA Panel. Clin Infect Dis. 2003 Jun 23;37(1):113–128. doi: 10.1086/375597. [DOI] [PubMed] [Google Scholar]
- Ickovics Jeannette R., Meade Christina S. Adherence to antiretroviral therapy among patients with HIV: a critical link between behavioral and biomedical sciences. J Acquir Immune Defic Syndr. 2002 Dec 15;31 (Suppl 3):S98–102. doi: 10.1097/00126334-200212153-00002. [DOI] [PubMed] [Google Scholar]
- Ioannou George N., Dominitz Jason A., Weiss Noel S., Heagerty Patrick J., Kowdley Kris V. Racial differences in the relationship between hepatitis C infection and iron stores. Hepatology. 2003 Apr;37(4):795–801. doi: 10.1053/jhep.2003.50147. [DOI] [PubMed] [Google Scholar]
- Kaserer K., Fiedler R., Steindl P., Müller C. H., Wrba F., Ferenci P. Liver biopsy is a useful predictor of response to interferon therapy in chronic hepatitis C. Histopathology. 1998 May;32(5):454–461. doi: 10.1046/j.1365-2559.1998.00413.x. [DOI] [PubMed] [Google Scholar]
- Kempf Dale J., King Martin S., Bernstein Barry, Cernohous Paul, Bauer Eric, Moseley Jennifer, Gu Kai, Hsu Ann, Brun Scott, Sun Eugene. Incidence of resistance in a double-blind study comparing lopinavir/ritonavir plus stavudine and lamivudine to nelfinavir plus stavudine and lamivudine. J Infect Dis. 2003 Dec 31;189(1):51–60. doi: 10.1086/380509. [DOI] [PubMed] [Google Scholar]
- Little Susan J., Holte Sarah, Routy Jean-Pierre, Daar Eric S., Markowitz Marty, Collier Ann C., Koup Richard A., Mellors John W., Connick Elizabeth, Conway Brian. Antiretroviral-drug resistance among patients recently infected with HIV. N Engl J Med. 2002 Aug 8;347(6):385–394. doi: 10.1056/NEJMoa013552. [DOI] [PubMed] [Google Scholar]
- Lochet P., Peyrière H., Lotthé A., Mauboussin J. M., Delmas B., Reynes J. Long-term assessment of neuropsychiatric adverse reactions associated with efavirenz. HIV Med. 2003 Jan;4(1):62–66. doi: 10.1046/j.1468-1293.2003.00136.x. [DOI] [PubMed] [Google Scholar]
- MacManus Sarah, Yates Phillip J., Elston Robert C., White Susan, Richards Naomi, Snowden Wendy. GW433908/ritonavir once daily in antiretroviral therapy-naive HIV-infected patients: absence of protease resistance at 48 weeks. AIDS. 2004 Mar 5;18(4):651–655. doi: 10.1097/00002030-200403050-00009. [DOI] [PubMed] [Google Scholar]
- Macías Juan, Castellano Victor, Merchante Nicolás, Palacios Rosa B., Mira José A., Sáez Carmen, García-García José A., Lozano Fernando, Gómez-Mateos Jesús M., Pineda Juan A. Effect of antiretroviral drugs on liver fibrosis in HIV-infected patients with chronic hepatitis C: harmful impact of nevirapine. AIDS. 2004 Mar 26;18(5):767–774. doi: 10.1097/00002030-200403260-00007. [DOI] [PubMed] [Google Scholar]
- Metwally Mohamed A., Zein Claudia O., Zein Nizar N. Clinical significance of hepatic iron deposition and serum iron values in patients with chronic hepatitis C infection. Am J Gastroenterol. 2004 Feb;99(2):286–291. doi: 10.1111/j.1572-0241.2004.04049.x. [DOI] [PubMed] [Google Scholar]
- Murphy D. A., Roberts K. Johnston, Hoffman D., Molina A., Lu M. C. Barriers and successful strategies to antiretroviral adherence among HIV-infected monolingual Spanish-speaking patients. AIDS Care. 2003 Apr;15(2):217–230. doi: 10.1080/0954012031000068362. [DOI] [PubMed] [Google Scholar]
- Nelson M., Schiavone M. Emtricitabine (FTC) for the treatment of HIV infection. Int J Clin Pract. 2004 May;58(5):504–510. doi: 10.1111/j.1368-5031.2004.00100.x. [DOI] [PubMed] [Google Scholar]
- Palella Frank J., Jr, Deloria-Knoll Maria, Chmiel Joan S., Moorman Anne C., Wood Kathleen C., Greenberg Alan E., Holmberg Scott D., HIV Outpatient Study Investigators Survival benefit of initiating antiretroviral therapy in HIV-infected persons in different CD4+ cell strata. Ann Intern Med. 2003 Apr 15;138(8):620–626. doi: 10.7326/0003-4819-138-8-200304150-00007. [DOI] [PubMed] [Google Scholar]
- Rivadeneyra R., Elderkin-Thompson V., Silver R. C., Waitzkin H. Patient centeredness in medical encounters requiring an interpreter. Am J Med. 2000 Apr 15;108(6):470–474. doi: 10.1016/s0002-9343(99)00445-3. [DOI] [PubMed] [Google Scholar]
- Roberts Kathleen Johnston. Physician-patient relationships, patient satisfaction, and antiretroviral medication Adherence among HIV-infected adults attending a public health clinic. AIDS Patient Care STDS. 2002 Jan;16(1):43–50. doi: 10.1089/108729102753429398. [DOI] [PubMed] [Google Scholar]
- Rodriguez-French Amalia, Boghossian Jack, Gray Glenda E., Nadler Jeffrey P., Quinones Arnaldo R., Sepulveda Gladys E., Millard Judith M., Wannamaker Paul G. The NEAT study: a 48-week open-label study to compare the antiviral efficacy and safety of GW433908 versus nelfinavir in antiretroviral therapy-naive HIV-1-infected patients. J Acquir Immune Defic Syndr. 2004 Jan 1;35(1):22–32. doi: 10.1097/00126334-200401010-00003. [DOI] [PubMed] [Google Scholar]
- Sherman Kenneth E. HCV and HIV: a tale of two viruses. Rev Gastroenterol Disord. 2004;4 (Suppl 1):S48–S54. [PubMed] [Google Scholar]
- Simon Viviana, Vanderhoeven Jeroen, Hurley Arlene, Ramratnam Bharat, Louie Michael, Dawson Keith, Parkin Neil, Boden Daniel, Markowitz Martin. Evolving patterns of HIV-1 resistance to antiretroviral agents in newly infected individuals. AIDS. 2002 Jul 26;16(11):1511–1519. doi: 10.1097/00002030-200207260-00008. [DOI] [PubMed] [Google Scholar]
- Smith Kimberly Y., Orgain Javette, Scott Robert. Disparities and gaps in HIV research and care. J Natl Med Assoc. 2004 Feb;96(2 Suppl):5S–7S. [PMC free article] [PubMed] [Google Scholar]
- Stone Valerie E. Optimizing the care of minority patients with HIV/AIDS. Clin Infect Dis. 2004 Jan 9;38(3):400–404. doi: 10.1086/380969. [DOI] [PubMed] [Google Scholar]
- Stone Valerie E., Smith Kimberly Y. Improving adherence to HAART. J Natl Med Assoc. 2004 Feb;96(2 Suppl):27S–29S. [PMC free article] [PubMed] [Google Scholar]
- Taylor G. P., Low-Beer N. Antiretroviral therapy in pregnancy: a focus on safety. Drug Saf. 2001;24(9):683–702. doi: 10.2165/00002018-200124090-00004. [DOI] [PubMed] [Google Scholar]
- Volberding Paul A., Levine Alexandra M., Dieterich Douglas, Mildvan Donna, Mitsuyasu Ronald, Saag Michael, Anemia in HIV Working Group Anemia in HIV infection: clinical impact and evidence-based management strategies. Clin Infect Dis. 2004 Apr 27;38(10):1454–1463. doi: 10.1086/383031. [DOI] [PubMed] [Google Scholar]
- Whitfield L. Black plague. Posit Aware. 1997 Sep-Oct;8(5):40-3, 45-6. [PubMed] [Google Scholar]
- Wong Mitchell D., Cunningham William E., Shapiro Martin F., Andersen Ronald M., Cleary Paul D., Duan Naihua, Liu Hong Hu, Wilson Ira B., Landon Bruce E., Wenger Neil S. Disparities in HIV treatment and physician attitudes about delaying protease inhibitors for nonadherent patients. J Gen Intern Med. 2004 Apr;19(4):366–374. doi: 10.1111/j.1525-1497.2004.30429.x. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Zeldin Robert K., Petruschke Richard A. Pharmacological and therapeutic properties of ritonavir-boosted protease inhibitor therapy in HIV-infected patients. J Antimicrob Chemother. 2003 Dec 4;53(1):4–9. doi: 10.1093/jac/dkh029. [DOI] [PubMed] [Google Scholar]
