Hispanic Women Receive HIV Treatment at Same Rate as Men Despite Greater Obstacles

Hispanic/Latina women in the US access treatment for HIV infection at the same rates as men despite facing more challenges, according to a new analysis of large population survey data by the Centers for Disease Control and Prevention (CDC).

As Hispanic/Latinos in the US have approximately double the prevalence of HIV infection as non-Hispanic whites, the investigators undertook this study to explore whether differences in care by gender in this underserved population might help inform and improve provision of services.

Ruthie Luna-Gierke, MPH, Epidemiologist, Division of HIV/AIDS Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, CDC, Atlanta, and colleagues analyzed data from the 2013 and 2014 cycles of the Medical Monitoring Project (MMP), an annual cross-sectional, nationally representative surveillance system. In the 2013-2014 cycle, the MMP collected information about behaviors, medical care, and clinical outcomes among adults receiving outpatient HIV treatment.

The investigators found similar rates of antiretroviral treatment (ART) and therapeutic outcomes in Hispanic/Latino women and men (96% vs 95% prescribed ART and 68% vs 73% sustained viral suppression). Women, however, were more likely than men to live in poverty (78% vs 54%), live in a household with ≥1 dependants <18 years of age (66% vs 37%) and report not speaking English well (38% vs 21%). In addition, women were less likely to have more than a high school education, employment, or private health insurance.

Luna-Gierke and colleagues note that poverty is known to affect management of HIV infection and characterize it as a paramount concern affecting all stages of the HIV care continuum. "Some ART regimens require food, thus lack of food might lead to nonadherence," they illustrated. "Lack of transportation might pose barriers to attending medical appointments and obtaining medications."

Although more women than men faced such challenges to receiving treatment, more women than men also accessed such ancillary services, such as a language interpreter (27% vs 16%), transportation (35% vs 21%), and meals (44% vs 26%), and more women obtained public health insurance (72% vs 54%).

"Despite facing greater socioeconomic and language-related challenges, Latina women receiving outpatient HIV care in the US had clinical outcomes that were similar to Latino men in care," Luna-Gierke told MD Magazine®. "Perhaps, due in part to the higher use of HIV support services by Latina women."

The investigators emphasize that while they found no disparities between the men and women in accessing treatment and sustaining viral suppression, Hispanics/Latinos in HIV care have higher levels of unmet needs for services than other populations. Successful treatment outcomes in this population are also substantially lower than the national prevention goal of at least 80% viral suppression for persons with diagnosed HIV infection.

"The findings underscore that providers should be aware of the challenges faced by all Latinos with HIV infection and provide referrals to support services such as assistance with translation, transportation, and meals, that can address those challenges," Luna-Gierke said.

The study, Differences in Characteristics and Clinical Outcomes Among Hispanic/Latino Men and Women Receiving HIV Medical Care-United States, 2013-2014 ,was published the CDC’s in Morbidity and Mortality Weekly Report (MMWR).