Examination of Inequalities in HIV/AIDS Mortality in the United States from a Fundamental Cause Perspective

In the current study, the researchers assessed changes in socioeconomic status (SES) and black and white inequalities in HIV/AIDS mortality prior to and after the introduction of highly active antiretroviral therapy (HAART). Taking a fundamental cause perspective, they used negative binomial regression to analyze trends in county-level gender-, race-, and age-specific HIV/AIDS mortality rates of persons ages 15 to 64. The study period was 1987 to 2005.

"Although HIV/AIDS mortality rates decreased once HAART became available, the declines were not uniformly distributed among population groups," the authors wrote. Associations between SES and HIV/AIDS mortality, as well as between race and HIV/AIDS mortality, were present in the pre-HAART period. In the peri- and post-HAART periods, however, these associations were significantly greater. During the post-HAART period, higher SES and white race were associated with the greatest declines in mortality.

"Our findings support the fundamental cause hypothesis, as the introduction of a life-extending treatment exacerbated inequalities in HIV/AIDS mortality by SES and by race," the authors concluded. "In addition to a strong focus on factors that improve overall population health, more effective public health interventions and policies would facilitate an equitable distribution of health-enhancing innovations."

The Friends of AIDS Foundation is dedicated to enhancing the quality of life for HIV positive individuals and empowering people to make healthy choices to prevent the spread of the HIV virus. To learn more about The Friends of AIDS Foundation, please visit: http://www.friendsofaids.org.


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