Gender differences in rates and reasons for stopping treatment
Polly Clayden, HIV i-Base
Sapna Shah and colleagues from the Royal Free Hospital, London, compared rates and reasons for stopping treatment between men and women.
This retrospective audit was performed using data from 785 drug naïve HIV-positive patients (initiating HAART (either PI or NNRTI containing) between 1996 and 2002.
Comparisons were made between genders and different treatment groups – one PI, one NNRTI, two PIs, >one NNRTI and one PI and one NNRTI.
Women made up 24% of the group and they were mostly black African (63%), heterosexual (90%) and their median age was 32 years, while the men were primarily white (79%) and homosexual (75%) with a median age of 35. The investigators found that men initiated HAART eight months before women from first diagnosis and at higher CD4 counts. Forty-seven per cent of women vs 39% of men began therapy on a single NNRTI containing regimen and 50% of men vs 42% of women started with a single PI containing regimen.
There were no significant differences between genders in reasons for stopping therapy overall and median time to stopping was shorter for women than for men, 422 vs 675 days, but not significantly (p=0.2). However differences were reported across treatment groups. Women were 22%, 40% and 700% more likely to stop a single PI, a single NNRTI and a dual PI regimen respectively than men.
The investigators concluded, “Median times to stopping/switching a first HAART regimen were quite long. Rates of stopping may be higher in women.”
Shah S, Smith C, Lampe FC et al. Gender differences in the rate of stopping highly active antiretroviral therapy (HAART). 9th BHIVA Conference, 24-26 April 2003, Manchester. Abstract P44