Chanelle Howe, PhD, Has Paper Accepted for Publication in the American Journal of Epidemiology

May 29, 2014

Assistant Professor of Epidemiology, Chanelle Howe, has paper "African American Race and HIV Virological Suppression: Beyond Disparities in Clinic Attendance" accepted for publication in the July issue of the American Journal of Epidemiology. Read the abstract below.

"Racial disparities in clinic attendance may contribute to racial disparities in plasma human immunodeficiency
virus type 1 (HIV-1) RNA levels among HIV-positive patients in care. Data from 946 African American and 535
Caucasian patients receiving HIV care at the University of North Carolina Center for AIDS Research HIV clinic between
January 1, 1999, and August 1, 2012, were used to estimate the association between African American race
and HIV virological suppression (i.e., undetectable HIV-1 RNA) when racial disparities in clinic attendance were
lessened. Clinic attendance was measured as the proportion of scheduled clinic appointments attended (i.e.,
visit adherence) or the proportion of six 4-month intervals with at least 1 attended scheduled clinic appointment
(i.e., visit constancy). In analyses accounting for patient characteristics, the risk ratio for achieving suppression
when comparing African Americans with Caucasians was 0.91 (95% confidence interval: 0.85, 0.98). Lessening
disparities in adherence or constancy lowered disparities in virological suppression by up to 44.4% and 11.1%,
respectively. Interventions that lessen disparities in adherence may be more effective in eliminating disparities in
suppression than interventions that lessen disparities in constancy. Given that gaps in care were limited to be no
more than 2 years for both attendance measures, the impact of lessening disparities in adherence may be