[643] DISPARITIES IN COMMUNITY UPTAKE OF TENOFOVIR IN SAN FRANCISCO, CALIFORNIA

2nd International AIDS Society Conference on HIV Pathogenesis and Treatment

Paris, France - July 13 - 16, 2003

[TITLE:] DISPARITIES IN COMMUNITY UPTAKE OF TENOFOVIR IN SAN FRANCISCO, CALIFORNIA

[AUTHOR(S):] SY Chen¹, D Bhattacharya², W McFarland¹ and D Katzenstein²
¹San Francisco Department of Public Health, San Francisco, USA; and ²Stanford University, Palo Alto, USA

IAS Conf HIV Pathog Treat 2003 Jul 13-16;2nd: Abstract No. 643
Antiviral Therapy 2003; 8(Suppl. 1):S361

[ABSTRACT:] Background: Despite the availability of free and effective treatment for HIV/AIDS to all residents of San Francisco, we have witnessed emerging disparities in the use of antiretroviral therapy, disease progression and death due to AIDS across communities. Tenofovir DF (TDF) was licensed in October of 2001 and its use is rapidly expanding for both salvage therapy and for drug-naïve patients. Using AIDS case surveillance data, we examined the community level uptake of TDF as a test case to characterize potential differences in the use of and benefit from new AIDS treatments.

Methods: Using citywide surveillance data, we conducted a retrospective review of all AIDS cases known to be alive between January 1999 and December 2002 (n=6898).

Results: 403 (5.8%) AIDS cases ever using TDF were identified. 26% were using TDF prior to licensure, suggesting participation in clinical trials. Persons not on TDF were more likely to be non-white, injection drug users, homeless and have no insurance. Data also suggest that patients from upper household income census tracts had greater access to TDF than those of lower household income census tracts prior to licensure.

Conclusions: TDF uptake was lower among minorities, injecting drug users, homeless, and the noninsured. Findings highlight a disquieting inequity of the American healthcare system that cannot be corrected simply by making AIDS treatment affordable or free.

030714
643