Overcoming challenges to successful treatment outcomes in minority patients with HIV/AIDS

Abstract

Improved HIV/AIDS outcomes and decreased mortality due to treatment with highly active antiretroviral therapy (HAART) in the USA have not benefited minorities to the same extent as whites.1,2 HIV/AIDS is one of the largest contributors to the gap in life expectancy between blacks and whites in the USA, because of disproportionate HIV infection rates as well as higher HIV-related death rates, which have persisted in the post-HAART era.1 Furthermore, HIV/AIDS is one of the key clinical areas in which disparities were found and documented in the Institute of Medicine report on health care disparities, Unequal Treatment.3 In addition, many other challenges and barriers may impede and complicate efforts to provide optimal care for minority persons living with HIV/AIDS in the USA. These include the competing life issues of patients who are living in poverty, such as joblessness and housing instability. For many women, the challenges can include domestic violence as well. Mental health issues and substance abuse also are prevalent in patients with HIV/AIDS and often serve as major barriers to effective treatment. © 2009 Springer-Verlag New York.