Differential Diffusion of HIV Technologies by Gender

The Case of Highly Active Antiretroviral Therapy

Published in: AIDS Patient Care and STDs, v. 21, no. 6, June 2007, p. 390-399

Posted on RAND.org on January 01, 2007

by David Eisenman, Laura M. Bogart, Chloe E. Bird, Rebecca L. Collins, Daniela Golinelli, Allen Fremont, Robin L. Beckman, William Cunningham

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The authors sought to examine whether diffusion of new HIV technologies differed by gender in the United States, the source of any such disparities, and whether disparities narrow over time as technologies become more established. In particular, the authors assess how rates of use of highly active antiretroviral therapy (HAART) varied between males and females during the late 1990s, when HAART was rapidly diffusing. The authors examined data from a prospective cohort study of a national probability sample of 1421 HIV-infected adults in medical care who were enrolled in the HIV Cost and Services Utilization Study (HCSUS) from January 1996 to December 1998. They found that HAART use substantially increased between 1996 and early 1998 for all groups. Women were less likely to receive HAART at all time points, although the diffusion of HAART between 1996 and 1998 reduced gender disparities. Gender disparities in 1998 were only partially explained by women's lower income and educational levels. The authors conclude that HAART therapy diffused more slowly to HIV-positive females than other groups. Policies that reduce the impact of income and education inequalities on health care may help to narrow gender disparities for new HIV technologies, but other factors may also disadvantage women.

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