The Socio-economic Inequalities and HIV Working Group for Collaboration of Observational HIV …
Inequalities by educational level in response to combination antiretroviral treatment and survival in HIV-positive men and women in Europe
background socioeconomic inequality challenges populationlevel implementation health interventions investigated differences educational level clinical virological immunological responses combined antiretroviral treatment cart hivpositive men women collaboration observational hiv epidemiological research europe european collaboration methods data pooled 15 cohorts eight countries patients initiating cart 19962013 data educational level categorized unescoisced classifications kaplanmeier curves cox piecewise linear mixed models used results 24 069 hivpositive patients 9 completed primary education 32 completed primary 44 secondary 15 tertiary education overall 21 women overrepresented lower educational strata 132 507 personyears followup 1081 individuals died cumulative mortality decreased higher educational level p 0001 122 765 personyears new aids events death occurred 2598 individuals differences education marked death alone p 0001 virological response achieved 67 patients without completed basic education 85 completed primary education 82 secondary 87 tertiary p 0001 patients higher education higher cd4 cell count cart initiation time cart rate cd4 cell count recovery differ differences mortality clinical responses similar men women entirely explained delayed hiv diagnosis late cart initiation conclusion hivpositive patients lower educational level worse responses cart survival european countries universal healthcare maximize population impact cart europe needs decrease socioeconomic divide