XVIII International AIDS Conference


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Racial healthcare disparity: HIV-related symptoms and side-effects of antiretroviral treatments experienced by American Asian/Pacific Islanders and substance use for symptom management

E. Kamitani1, C. Dawson-Rose1, W.L. Holzemer1, C. Portillo1, P.K. Nicholas2, E. Sefcik3, K.M. Kirksey4, S. Willard1, D. Wantland1, I.B. Corless2, M. Rivero-Méndez5, M.J. Hamilton3, J. Kemppainen6, L. Robinson7, S. Moezzi8, J. Arudo9, M. Maryland10, S. Human11, M. Rosa12, A.R. Wabel13

1University of California, San Francisco, School of Nursing, San Francisco, United States, 2MGH Institute of Health Professions, Schoo of Nursing, Boston, United States, 3Texas A & M University, Corpus Christi, United States, 4Setpn Family of Hospitals, Austin, United States, 5University of Puerto Rico, San Juan, Puerto Rico, 6The University of North Carolina at Wilmington, Crolina Beach, United States, 7University of San Diego, San Diego, United States, 8University of Utah, Salt Lake City, United States, 9Aga Khan University Advanced Nursing Programme, Nairobi, Kenya, 10University of Illinois at Chicago College of Medicine, Chicago, United States, 11University of South Africa, Pretoria, South Africa, 12Institute for Hispanic Health, Washington, United States, 13Frances Payne Bolton School of Nurseing Case Western Reserve University, Cleveland, United States

Background: Healthcare disparities and substance use in people living with HIV (PLWHA) has been documented, however, little is known about their impact among HIV-infected American Asian/Pacific Islanders (AAPI). The number of HIV cases is increasing at a higher rate for AAPI than for any other group, and AAPI compose the only racial/ethnic group with an increase in the incidence of AIDS cases. The purposes of this study were to (1) compare HIV and antiretroviral (ARV)-related symptoms experienced by AAPI and others and (2) examine substance use as a symptom management strategy among PLWHA in care.
Methods: This study evaluated baseline data from a multi-national RCT with 775 HIV-infected individuals: 165 (21.3%) non-Hispanic whites, 337 (43.5%) African Americans (AA), 216 (27.9%) Hispanics, 11 (1.4%) AAPI, 8 (1.0%) Native Americans (NA), and 38 (4.9%) other. Study participants were asked if they experienced common HIV-related or ARV treatment symptoms including anxiety, depression, diarrhea, fatigue, nausea, and neuropathy. Participants who reported any of these symptoms were asked if they used substances including marijuana, cigarettes, alcohol, and street drugs as a symptom management strategy.
Results: AAPI reported higher rates of occurrence for all symptoms except nausea than any other group; especially there is a statistically significance difference in occurrence of depression symptom between AAPI and AA (p=.008, chi-square tests followed by Bonferroni post hoc test). Marijuana use among AAPI with depression (33%), diarrhea (67%) was significantly higher than within any other ethnic group. AAPI with depression (67%) or anxiety (67%) reported the highest cigarette use.
Conclusions: The results of this study suggest that AAPI are more likely to suffer from HIV-related symptoms and the side-effects of ARV than other racial and ethnic groups. Marijuana and cigarettes may be more commonly used in this population than in other groups to manage unwanted symptoms especially depression and anxiety.

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