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Black People Experience Less Viral Suppression

By Jeff Berry and Enid Vázquez

November/December 2012

Black people have less HIV virologic success (as shown by a drop in their viral load) than whites, according to a look at six gold-standard studies in HIV treatment with a total of nearly 5,000 individuals (called a "meta-analysis").

According to a summary from lead author Christopher Evans, M.D., M.P.H., of AIDS ARMS in Dallas, "Comparison by race highlighted the fact that [b]lacks still experienced higher rates of virologic failure regardless of their underlying HAART [highly active antiretroviral therapy] regimen."

In the summary, Evans explains that, "Failure to suppress replicating HIV virus in [b]lack participants in clinical trials has looming implications for the individual ... especially if there is a consensus to meet the goals set forth in policies outlined in the National HIV/AIDS strategy.

"Considering the overwhelming evidence that successful HIV treatment positively impacts morbidity [illness], mortality, and community prevention," he continues, "it should be an essential goal of both policy makers and research initiatives to understand the drivers of the inequities demonstrated in clinical trials.

"The impact of social factors," he noted, "such as mental health, cost, health literacy, and food security, on HAART and virologic failure has been examined in other studies, but there is not a clear correlation with social disparities, race, and virologic failures. In studies that have tried to control for some factors such as education and social support, this virologic disparity still persisted between [b]lacks and other groups."

He noted that the difference may be explained by such factors as pharmacokinetic differences, psychosocial barriers to adherence, patient-provider relationships, care delivery models, and societal and cultural issues.


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