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African Americans infected with HIV-1, the virus that causes AIDS, appear to be less likely than whites to get treated for AIDS or an AIDS-related disease before they are referred to an HIV clinic, according to a study by researchers at The Johns Hopkins University School of Medicine.
The results suggest that it may be necessary to promote early care in African American communities, both for treatment with anti- drugs such as AZT, and for preventive treatment for Pneumocystis carinii pneumonia (PCP), according to an article published this week in the New England Journal of Medicine. PCP commonly occurs in advanced cases of AIDS, when the person's immune system has been weakened by AIDS.
The Hopkins researchers found that this racial difference in treatment was not caused by differences in income, medical insurance, sex, age, level of education, place of residence or the way was transmitted.
'There's also evidence of a racial difference in access to some other types of medical care," says Richard D. Moore, M.D., associate professor of medicine and the lead author of the paper.
"Our study doesn't identify the reason for this difference in treatment of AIDS or PCP. But it may be that patients aren't seeking care for some reason, don't receive it, have not had the treatment fully explained to them or might not follow through to get treatment after it's offered."
Before coming for treatment to The Johns Hopkins hospital AIDS Service, 48 percent of African Americans had received AZT, versus 63 percent of whites. And only 58 percent of African Americans had received preventive treatment for PCP, while 82 percent of whites had received the treatment.
However, during a six-month follow-up by Hopkins doctors, there were no racial differences in either anti-HIV therapy or PCP preventive treatment. This suggests that without a center dedicated to the treatment of HIV disease, racial inequalities in the care of patients infected with may persist, the researchers say.
The study included 838 patients from the Baltimore metropolitan area, of whom 656 (79 percent) were African American, 167 (20 percent) were non-Hispanic whites, and 15 (2 percent) were of Asian descent or not racially classified. There were 581 males and 257 females, of whom 88 percent lived in Baltimore.
The study was supported by a grant from the Agency for Health Care Policy and Research and by a contract from the Maryland Department of Health and Mental Hygiene.