Black-white differences in HIV care seen in US

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The level of care given to black patients with HIV in the US seems to depend on the whether the doctor is black or white, new study findings show.

Specifically, African-Americans with HIV who were treated by white doctors tended to receive potent anti-HIV drugs known as protease inhibitors after they became available in the mid 90s several months later than did those treated by African-American doctors.

These findings are reported by Dr. William D. King, at the University of California Los Angeles, and his colleagues with the HIV Cost and Services Utilization Study.

One way for minority patients to combat these trends would be to “arm themselves with information and educate themselves about their health care, so they are able to work with physicians in partnership regarding their health care,” King said. Sources of such information include the Internet and educational workshops.

“Then if they realize their doctor is deviating from the standard of care or they’re not getting the care they need, they can show their discontent, either verbally or by...finding themselves another physician,” King advised

According to the article in the Journal of General Internal Medicine, King’s study involved 1241 patients and 287 health care providers, recruited soon after protease inhibitors were approved by the FDA for treating HIV.

Sixty-one percent of participants were white with white providers, 32 percent were African American with white providers, 6 percent were African American with African-American providers, and less than 1 percent were white with African-American providers.

The investigators found that white patients started protease-inhibitor treatment an average of 277 days after FDA approval, while it took 439 days on average before African American patients were prescribed the drugs.

However, there was no delay in protease inhibitor use among African-American patients with African-American providers, relative to white patients with white providers.

One problem that could account for these findings is that “less than 3 percent of all physicians—primary care providers and specialists combined—are African American,” King noted in an interview with Reuters Health. So a primary goal to rectify differences in patient care is to increase the supply of African-American physicians, he added.

SOURCE: Journal of General Internal Medicine, November 2004.

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