My Authors
Read all threads
1/ What do #racism & #redlining have to do with inequities in #HIV outcomes?

Our new study just published in #ClinInfectDis examines neighborhood deprivation, race/ethnicity, and HIV viral suppression. Thread 👇🏾

#MedTwitter #MedStudentTwitter #IDTwitter

doi.org/10.1093/cid/ci… ACCEPTED MANUSCRIPT "Neighborhood Deprivation and Racia
2/ #Redlining in the 1930s involved racialized federal mapping of housing "desirability" (L) --> ⬆️💰 into White/affluent areas + systematic disinvestment in "undesirable" areas.

To this day, HOLC maps of urban areas like Omaha STILL align w/deprivation & racial segregation (R). An official U.S. Home Owners Loan Corporation (HOLC) map of Area Deprivation Index (ADI) map of the Greater Omaha Area, Racial Dot Map of Greater Omaha Area, demonstrating clear pr
3/ Omaha is among the most segregated U.S. cities. Our HIV clinic serves ~50% Black and Latinx pts, who disproportionately live in deprived neighborhoods.

We assessed neighborhood disadvantage using the ADI, outlined by @amyjhkind et al. in @NEJM.

nejm.org/doi/full/10.10…
4/ Our analysis found:

✅Viral suppression rates among Black ppl w/HIV (PWH) < White PWH

✅Black-White differences were non-significant after adjusting for age, sex, income, ADI, rurality

✅ADI & poverty independently & inversely assoc. w/suppression

doi.org/10.1093/cid/ci… Table 1 – Independent predictors of HIV viral suppression.
5/ Why does this matter?

As we aim to #EndHIVEpidemic, we need to think beyond the clinic walls. The *structural* -isms require *structural* interventions.

The phenomenal Invited Commentary by Doshi et al. expands on our brief discussion section 👇🏾

doi.org/10.1093/cid/ci… ACCEPTED MANUSCRIPT "Tying Structural Racism to HIV Vir
6/ Building #structuralcompetency in #MedEd (h/t @JonathanMetzl & Helena Hanson) is critical to understanding sociopolitical drivers of inequity like #redlining.

At @UNMC, @DrJRMarcelin and I partner with our community to start these conversations early.
7/ #HIV advocacy must similarly center structural interventions, including broad suggestions from Doshi et al:
✅Changes in welfare policy
✅Integrated models of care
✅Comprehensive sex education
✅Harm reduction programs
✅Protecting the rights of sexual/gender minorities
8/ In sum: To reduce HIV inequities, we need to dismantle -isms & intervene upon systemic (> individual) drivers.

Gratitude to @shurtadobares @DrJRMarcelin, truly incredible research (and life! ☺️) mentors, and to our @UNMC_ID clinic team & patients!

doi.org/10.1093/cid/ci…
Missing some Tweet in this thread? You can try to force a refresh.

Keep Current with Rohan Khazanchi 😷

Profile picture

Stay in touch and get notified when new unrolls are available from this author!

Read all threads

This Thread may be Removed Anytime!

Twitter may remove this content at anytime, convert it as a PDF, save and print for later use!

Try unrolling a thread yourself!

how to unroll video

1) Follow Thread Reader App on Twitter so you can easily mention us!

2) Go to a Twitter thread (series of Tweets by the same owner) and mention us with a keyword "unroll" @threadreaderapp unroll

You can practice here first or read more on our help page!

Follow Us on Twitter!

Did Thread Reader help you today?

Support us! We are indie developers!


This site is made by just two indie developers on a laptop doing marketing, support and development! Read more about the story.

Become a Premium Member ($3.00/month or $30.00/year) and get exclusive features!

Become Premium

Too expensive? Make a small donation by buying us coffee ($5) or help with server cost ($10)

Donate via Paypal Become our Patreon

Thank you for your support!