AEGiS-SFE: AIDS study finds race, gender linked to care; Women, minority men more likely to delay treatment

Important note: Information in this article was accurate in 1998. The state of the art may have changed since the publication date.

AIDS study finds race, gender linked to care; Women, minority men more likely to delay treatment

The San Francisco Examiner; June 4, 1998
Eun Lee Koh, Examiner Washington Bureau

WASHINGTON - Women and minority men are more likely than white men to delay seeking treatment for AIDS, and they tend to receive less effective care for the deadly disease, according to a new study.

Researchers from UC-San Francisco and Johns Hopkins University in Baltimore found that a larger proportion of women and minorities than white men sought treatment for HIV, the virus that causes AIDS, after their immune system had already broken down.

Dr. Paul Volberding, professor of medicine at UC-San Francisco, said poorer patients tended to put off treatment to avoid early medical costs until they began experiencing symptoms.

Women and minorities infected with HIV are generally poorer than infected white men.

"Early in the disease, there's almost no physical change to the body," Volberding said. "Patients mistakenly believe that just because they seem healthy, they don't need to be treated right away."

According to the study, released Wednesday, 36 percent of women, 42 percent of blacks and 43 percent of Latinos waited until their T-cell counts had dipped below 500 to seek treatment, while only 27 percent of white men waited that long.

T-cells are white blood cells that protect the body against diseases.

The U.S. Department of Health and Human Services recommends treating AIDS patients before their T-cell count dips below 500, but many of the patients who delayed treatment had T-cells below the recommended level. Healthy people have more than 1,000 T-cells per 1 milliliter of blood.

The study did not examine the causes for the disparity, but researchers suggested that economics probably played a large role in the difference in the quality of AIDS treatment that patients receive.

In order to slow the breakdown of the immune system, Volberding said a patient should seek treatment immediately after being diagnosed with HIV.

The study also found that 76 percent of women, 68 percent of blacks and 65 percent of Hispanics infected with HIV sought care from physicians who did not specialize in AIDS treatment, compared with 54 percent of white men who did.

John Bartlett, chief of infectious diseases at the Johns Hopkins medical school, said physicians with little experience in AIDS treatment tended to offer their patients "second-best" treatment options.

The Health and Human Services Department recommends fighting HIV with at least three different types of medicine to slow the virus in its attack of the immune system. But some doctors in the survey said they had prescribed only one.

"The disparity in the treatment of HIV, especially for particular populations, signals an urgent need to educate physicians and patients more aggressively," Volberding said.

Volberding said delayed treatment could lead to earlier death because the disease became harder to treat once it developed into full-blown AIDS and the immune system started breaking down. There is no cure for AIDS.

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