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Author Arnold, Michael ♦ Hsu, Ling ♦ Pipkin, Sharon ♦ McFarland, Willi ♦ Rutherford, George W.
Source World Health Organization (WHO)-Global Index Medicus
Content type Text
Publisher Elsevier
File Format HTM / HTML
Language English
Difficulty Level Medium
Subject Domain (in DDC) Social sciences ♦ Sociology & anthropology ♦ Social problems & services; associations ♦ Social welfare problems & services ♦ Natural sciences & mathematics ♦ Chemistry & allied sciences ♦ Life sciences; biology ♦ Biochemistry ♦ Natural history of organisms ♦ Technology ♦ Medicine & health ♦ Pharmacology and therapeutics ♦ Diseases ♦ Management & auxiliary services ♦ General management ♦ Manufacture for specific uses ♦ Precision instruments & other devices
Subject Domain (in MeSH) Eukaryota ♦ Organisms ♦ Virus Diseases ♦ Diseases ♦ Chemical Actions and Uses ♦ Chemicals and Drugs ♦ Investigative Techniques ♦ Analytical, Diagnostic and Therapeutic Techniques and Equipment ♦ Social Sciences ♦ Anthropology, Education, Sociology and Social Phenomena ♦ Persons ♦ Persons ♦ Health Services Administration ♦ Health Care ♦ Geographic Locations ♦ Geographic Locations
Subject Keyword Discipline Medicine ♦ Continental Population Groups ♦ Hiv Infections ♦ Drug Therapy ♦ Healthcare Disparities ♦ Social Class ♦ Survival Analysis ♦ Adolescent ♦ Adult ♦ Anti-retroviral Agents ♦ Therapeutic Use ♦ Censuses ♦ Female ♦ Humans ♦ Male ♦ Middle Aged ♦ Proportional Hazards Models ♦ San Francisco ♦ Young Adult ♦ Journal Article
Abstract Prior evidence suggests that the health and longevity benefits of antiretroviral therapy (ART) for persons living with AIDS (PLWAs) have not been equally distributed across racial/ethnic groups in the United States. Notably, black PLWAs tend to fare worse than their counterparts. We examine the role of neighborhood socioeconomic context on racial/ethnic differences in AIDS treatment and survival in San Francisco. The study population encompassed 4211 San Francisco residents diagnosed with AIDS between 1996 and 2001. Vital status was reported through 2006. Census data were used to define neighborhood-level indicators of income, housing, demographics, employment and education. Cox proportional hazards models were employed in multivariate analyses of survival times. Compared to whites, blacks had a significant 1.4 greater mortality hazard ratio (HR), which decreased after accounting for ART initiation. PLWAs in the lowest socioeconomic neighborhoods had a significant HR of 1.4 relative to those in higher socioeconomic neighborhoods, independent of race/ethnicity. The neighborhood association decreased after accounting for ART initiation. Path analysis was used to explore causal pathways to ART initiation. Racial/ethnic differences in neighborhood residence accounted for 19-22% of the 1.6-1.8 black-white relative odds ratio (ROR) and 14-15% of the 1.3-1.4 Latino-white ROR for delayed or no treatment. Our findings illuminate the independent and synergistic contributions of race and place on treatment disparities and highlight the need for future studies and interventions to address treatment initiation as well as neighborhood effects on treatment differences.
Spatial Coverage San Francisco
Description Country affiliation: United States
Author Affiliation: Arnold M ( Center for AIDS Prevention, University of California San Francisco, 50 Beale Street, Suite 1300, San Francisco, CA 94105, USA. m_arnold@hotmail.com)
ISSN 02779536
Educational Role Student ♦ Teacher
Age Range above 22 year
Educational Use Reading ♦ Research ♦ Self Learning
Interactivity Type Expositive
Education Level UG and PG
Learning Resource Type Article
Publisher Date 2009-07-01
Publisher Place Great Britain (UK)
e-ISSN 18735347
Journal Social Science & Medicine
Volume Number 69
Issue Number 1


Source: WHO-Global Index Medicus