Paying the Price for Late Starts and Early Stops: Racial and Sex Disparities in HIV-Related Mortality

(See the article by Losina et al, on pages 1570–8.) It is well documented that black and His-panic individuals are significantly over-represented among individuals with hu-man immunodeficiency virus (HIV) infec-tion and/or AIDS in the United States. Equally concerning is the fact that black individuals who are infected with HIV, compared with their white counterparts, have a higher mortality rate and shorter time to death after HIV diagnosis. After the introduction of highly active antiret-roviral therapy (HAART) in 1996, AIDS-related mortality decreased significantly until 1998, at which point it leveled off, remaining essentially unchanged through 2005. The percentage of decrease was smallest for black individuals, particu-larly black women, who experienced a 44 % decrease, compared with a 79 % de-crease among white men [1]. In 2007, 9436 black or Hispanic individuals died as a result of HIV-related disease; this is more than double the number of white individuals who died of such causes in the same year [2]. Eighty-four percent of white patients survived 136 months afte