Black:White Disparities in HIV Mortality in the United States: 1990–2009
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The aim of this study was to assess whether racial disparities in human immunodeficiency virus (HIV) mortality in the USA have changed over time.
Using vital records from the National Center for Health Statistics and census data from the US Census Bureau, we calculated the race- and gender-specific HIV mortality rates and corresponding racial rate ratios for non-Hispanic Blacks and non-Hispanic Whites in the USA for four 5-year increments from 1990–2009. Rates were age-adjusted using the 2000 USA standard population. Additionally, we calculated excess Black deaths for 2005–2009.
For the total, male, and female populations, we observed a statistically significant increase in the Black:White HIV mortality disparity between T1 (1990–1994) and T4 (2005–2009). The increasing disparity was due to the fact that the decrease in mortality rates from T1 to T4 was greater among Whites than Blacks. This disparity led to 5603 excess Black deaths in the USA at T4.
Previous research suggests that as HIV becomes more treatable, racial disparities widen, as observed in this study for both men and women. Existing disparities could be ameliorated if access to care were equal among these groups. Equal access would enable more individuals to achieve viral suppression, the final step of the HIV Care Continuum.
KeywordsHIV mortality Disparities HIV excess deaths
We would like to acknowledge the dedication, leadership and mentorship of Dr. Steven Whitman, former Executive Director of the Sinai Urban Health Institute, who passed away in July 2014. His work in the field of HIV early in the epidemic and his passion for ending health disparities has motivated this analysis.
Conflicts of Interest
The authors declare that they have no competing interests.
No animal or human studies were carried out by the authors for this analysis.
Monique Glover Rucker receives salary support from Gilead Sciences, Inc. as part of the HIV FOCUS program.
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