African-Americans with HIV less likely to adhere to ART therapy

Published on May 3, 2012 at 1:13 AM · No Comments

African-Americans with HIV are much less likely to adhere to drug therapy than others with the disease, according to a University of Michigan study.

Moreover, untreated depression may greatly hinder adherence to antiretroviral therapy (ART) for all low-income, HIV-infected patients, regardless of race.

The study is the first known to indicate a true racial disparity in antiretroviral therapy adherence, says Rajesh Balkrishnan, associate professor at the University of Michigan School of Public Health and the College of Pharmacy. Less than 30 percent of African-American HIV patients in the one-year study sustained optimal adherence to ART, compared to 40 percent of other HIV patients.

"Our results show an alarming disparity in the quality of pharmaceutical care provided to African-American Medicaid enrollees with HIV," Balkrishnan said. "These enrollees have much lower adherence rates to ARTs and a 10 percent higher incidence of depression."

More than 66 percent of the 7,034 HIV-infected patients in the study were African-American and nearly half of them reported depression.

The good news is that antidepressant treatment nearly doubled the odds of optimal ART adherence among patients of all races who reported depression, Balkrishnan says. Anything greater than 90 percent adherence to therapy was considered optimal for purposes of the study. For antiretroviral drugs to be effective, patients should sustain 90-95 percent adherence to treatment.

Balkrishnan's research group set out to examine the possible link between race and ART adherence in low income HIV-infected populations, and whether any racial differences in therapy adherence was further enhanced by depression. Racial disparities exist in many aspects of HIV/AIDS, but until now not much was known about race and ART adherence, or depression and adherence.

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