2010/04/20 by Marcie S. Rubin, Cynthia G. Colen, Bruce G. Link · 1 citation
Health Professions · Medicine · #Adolescent Sexual and Reproductive Health #HIV-related health complications and treatments #HIV/AIDS Research and Interventions
paper · doi:10.2105/ajph.2009.170241
openalex publication_date 2010/04/20 · openalex created_date 2025/10/10 · openalex updated_date 2026/07/07
OBJECTIVES: We examined changes in socioeconomic status (SES) and Black to White inequalities in HIV/AIDS mortality in the United States before and after the introduction of highly active antiretroviral therapy (HAART). METHODS: Taking a fundamental cause perspective, we used negative binomial regression to analyze trends in county-level gender-, race-, and age-specific HIV/AIDS mortality rates among those aged 15 to 64 years during the period 1987-2005. RESULTS: Although HIV/AIDS mortality rates decreased once HAART became available, the declines were not uniformly distributed among population groups. The associations between SES and HIV/AIDS mortality and between race and HIV/AIDS mortality, although present in the pre-HAART period, were significantly greater in the peri- and post-HAART periods, with higher SES and White race associated with the greatest declines in mortality during the post-HAART period. CONCLUSIONS: Our findings support the fundamental cause hypothesis, as the introduction of a life-extending treatment exacerbated inequalities in HIV/AIDS mortality by SES and by race. In addition to a strong focus on factors that improve overall population health, more effective public health interventions and policies would facilitate an equitable distribution of health-enhancing innovations.