@article{214200cb2e89499b9ca0e17a389f7cd2,
title = "Sex, race, and geographic region influence clinical outcomes following primary HIV-1 infection",
abstract = "Background. It is unknown whether sex and race influence clinical outcomes following primary human immunodeficiency virus type 1 (HIV-1) infection. Methods. Data were evaluated from an observational, multicenter, primarily North American cohort of HIV-1 seroconverters. Results. Of 2277 seroconverters, 5.4% were women. At enrollment, women averaged .40 log10 fewer copies/mL of HIV-1 RNA (P < .001) and 66 more CD4+ T cells/lL (P = .006) than men, controlling for age and race. Antiretroviral therapy (ART) was less likely to be initiated at any time point by nonwhite women and men compared to white men (P < .005), and by individuals from the southern United States compared to others (P = .047). Sex and race did not affect responses to ART after 6 months (P > .73). Women were 2.17-fold more likely than men to experience >1 HIV/AIDS-related event (P < .001). Nonwhite women were most likely to experience an HIV/AIDS-related event compared to all others (P = .035), after adjusting for intravenous drug use and ART. Eight years after diagnosis, >1 HIV/AIDS-related event had occurred in 78% of nonwhites and 37% of whites from the southern United States, and 24% of whites and 17% of nonwhites from other regions (P < .001). Conclusions. Despite more favorable clinical parameters initially, female HIV-1-seroconverters had worse outcomes than did male seroconverters. Elevated morbidity was associated with being nonwhite and residing in the southern United States.",
author = "Meditz, {Amie L.} and Samantha MaWhinney and Amanda Allshouse and William Feser and Martin Markowitz and Susan Little and Richard Hecht and Daar, {Eric S.} and Collier, {Ann C.} and Joseph Margolick and Kilby, {J. Michael} and Routy, {Jean Pierre} and Brian Conway and John Kaldor and Jay Levy and Robert Schooley and Cooper, {David A.} and Marcus Altfeld and Douglas Richman and Elizabeth Connick",
note = "Funding Information: We acknowledge the participating sites: United States: University of Minnesota, Minneapolis, MN; University of Cincinnati, Cincinnati, OH; Northwestern University, Chicago, IL; Rush University, Chicago, IL; SUNY Downstate, Brooklyn, NY; Columbia University, NY, NY; Fenway Community Health, Boston, MA; Community Research Initiative of New England, Boston, MA; Brigham and Women{\textquoteright}s Hospital, Boston, MA; Beth Israel Medical Center, Boston, MA; University of Pennsylvania, Philadelphia, PA; Vanderbilt University, Nashville, TN; Duke University Medical Center, Durham, NC; University of Rochester, Rochester, NY; University of Texas Southwestern, Dallas, TX; University of Colorado Denver, Aurora, CO; Aaron Diamond AIDS Research Center, Rockefeller University, New York, NY; University of California, San Diego, San Diego, CA; Cedars-Sinai, Los Angeles, CA; University of California, San Francisco, San Francisco, CA; Los Angeles Biomedical Research Institute at Harbor– University of California, Los Angeles Medical Center, Torrance, CA; University of Washington Primary Infection Clinic, Seattle, WA; Johns Hopkins University, Baltimore, MD; University of Alabama, Birmingham, AL; Partners AIDS Research Center, Boston, MA; Canada: McGill University Health Centre, Montreal; University of British Columbia, Vancouver; Australia: The Centre Clinic, St Kilda, VIC; Prahran Market Clinic, St Kilda, VIC; Carlton Clinic, Carlton, VIC; Taylor Square Private Clinic, Darlinghurst, NSW; 407 Doctors, Darlinghurst, NSW; Holdsworth House General Practice, Darlinghurst, NSW; St Vincent{\textquoteright}s Hospital, Darlinghurst, NSW; The Alfred Clinic, Prahran, VIC; Melbourne Sexual Health Clinic, Carlton, VIC; AIDS Research Initiative, Darlinghurst, NSW; Brazil: Centro de Referencia Estadual de AIDS, Salvador, Bahia. Funding Information: This work was supported by the National Institutes of Health, National Institute of Allergy and Infectious Diseases (grant numbers AI41532, AI41531, AI41535, AI43638, AI41535 AI57005, AI41536, AI43271, AI41530, AI41534, AI52403, and AI57005).",
year = "2011",
month = feb,
day = "15",
doi = "10.1093/infdis/jiq085",
language = "English (US)",
volume = "203",
pages = "442--451",
journal = "Journal of Infectious Diseases",
issn = "0022-1899",
publisher = "Oxford University Press",
number = "4",
}