The Intersection of HIV, Diabetes, and Race: Exploring Disparities in Diabetes Care among People Living with HIV

J Int Assoc Provid AIDS Care. 2020 Jan-Dec:19:2325958220904241. doi: 10.1177/2325958220904241.

Abstract

In a setting of universal health care access, we compared diabetes control between Caucasians and African Americans (AA) living with HIV. This was a cross-sectional analysis of data from a cohort study among military members living with HIV and diabetes. Using adjusted logistic regression models, we compared proportions of Caucasians and AA meeting the following diabetes treatment goals: hemoglobin A1c <7.0%, blood pressure (BP) <140/90 mm Hg, low density lipoprotein cholesterol <100 mg/dL, and not smoking. We included 107 Caucasian (mean age 37 years) and 126 AA (mean age 33 years) participants. A similar proportion of Caucasians and AA were prescribed diabetes (∼60%) and BP (∼80%) medications. Yet, more Caucasians met the BP treatment goal (77% [54%, 90%]) than AA (61% [36%, 82%]). Thus, more Caucasians met the combined A1c, BP, and cholesterol goals for diabetes control (25% [10%, 49%]) than AA (13% [5%, 31%]). Despite having equal access to health care, AA in this study have poorer diabetes control than Caucasians.

Keywords: care continuum; equity; patient care; race.

Publication types

  • Comparative Study
  • Multicenter Study
  • Research Support, N.I.H., Extramural
  • Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

  • Adult
  • Black or African American / statistics & numerical data
  • Blood Pressure
  • Cholesterol, LDL
  • Continuity of Patient Care
  • Cross-Sectional Studies
  • Diabetes Complications
  • Diabetes Mellitus / ethnology
  • Diabetes Mellitus / prevention & control*
  • Diabetes Mellitus / therapy*
  • Female
  • Glycated Hemoglobin / analysis
  • HIV Infections / epidemiology*
  • HIV Infections / ethnology
  • Health Services Accessibility / standards*
  • Health Services Accessibility / statistics & numerical data
  • Healthcare Disparities / ethnology*
  • Humans
  • Male
  • Middle Aged
  • Prospective Studies
  • White People / statistics & numerical data

Substances

  • Cholesterol, LDL
  • Glycated Hemoglobin A